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General NPI Number Information
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NPI Number | 1518390335
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Entity Type | Organization
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Legal Business Name | THE FOOT DOCTORS & WOUND CARE SPECIALISTS PC
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Dates
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Enumeration Date | 08/15/2013
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Last Update Date | 08/15/2013
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Provider Practice Location Address
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Address Line | 8008 ROUTE 130 SUITE 310
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City | DELRAN
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State | NJ
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Zip | 08075-1869
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Country | US
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Telephone | 856-393-8771
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Fax | 856-393-8767
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Provider Business Mailing Address
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Address Line | 64 VILLAGE DR
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City | BARNEGAT
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State | NJ
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Zip | 08005-1671
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Country | US
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Telephone | 856-393-8771
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Fax | 856-393-8767
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | LYNN BANKERT
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Credential |
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Telephone | 856-393-8771
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP1100X
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Taxonomy Name | Podiatric Clinic/Center
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License Number |
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License Number State |
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