| NPI | 1477739654 |
|---|---|
| Doing Business As | LAKE RIDE PODIATRY |
| Entity Type | Organization |
| Authorized Contact | GERARD J RANIERI Sole Proprietor 703-491-2603 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2008-01-17 |
| Last Update Date | 2008-06-16 |