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General NPI Number Information
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NPI Number | 1093167389
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Entity Type | Organization
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Legal Business Name | NEIGHBORHOOD PODIATRY
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Dates
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Enumeration Date | 07/11/2016
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Last Update Date | 07/11/2016
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Provider Practice Location Address
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Address Line | 29 PIRATES COVE DR
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City | SWANSBORO
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State | NC
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Zip | 28584-8362
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Country | US
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Telephone | 864-663-3338
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Fax |
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Provider Business Mailing Address
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Address Line | 29 PIRATES COVE DR
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City | SWANSBORO
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State | NC
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Zip | 28584-8362
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Country | US
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Telephone | 864-663-3338
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. TROY HARRIS
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Credential | DPM
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Telephone | 864-663-3338
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | POD001252
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License Number State | GA
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