Healthcare Provider Details

I. General information

NPI: 1093334351
Provider Name (Legal Business Name): BRETT SALTRICK DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/15/2020
Last Update Date: 07/03/2024
Certification Date: 07/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

145 W 23RD ST STE 302A
ERIE PA
16502-2858
US

IV. Provider business mailing address

145 W 23RD ST STE 302A
ERIE PA
16502-2858
US

V. Phone/Fax

Practice location:
  • Phone: 814-835-3751
  • Fax: 814-835-3755
Mailing address:
  • Phone: 814-835-3751
  • Fax: 814-835-3755

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberN00007356-01
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberSC007422
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: