| NPI | 1922009703 |
|---|---|
| Former Legal Business Name | WOODBURN PODIATRY CENTER |
| Entity Type | Organization |
| Authorized Contact | DAVID L PONTELL President 703-849-8400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery |
| Enumeration Date | 2005-08-03 |
| Last Update Date | 2011-09-07 |