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General NPI Number Information
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NPI Number | 1265699201
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Entity Type | Organization
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Legal Business Name | MJ6 ENTERPRISES PC
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Dates
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Enumeration Date | 05/19/2008
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Last Update Date | 05/19/2008
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Provider Practice Location Address
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Address Line | 51 GOLDFINCH CIR
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City | PHOENIXVILLE
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State | PA
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Zip | 19460-1001
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Country | US
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Telephone | 717-567-9100
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Fax |
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Provider Business Mailing Address
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Address Line | 900 CENTURY DR SUITE 101
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City | MECHANICSBURG
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State | PA
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Zip | 17055-4525
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Country | US
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Telephone | 717-766-1066
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MARK E WINTERSTEEN
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Credential | DPM
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Telephone | 717-567-9100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | SC004446R
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License Number State | PA
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