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General NPI Number Information
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NPI Number | 1740329218
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Entity Type | Organization
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Legal Business Name | RAYSTOWN PODIATRY ASSOCIATES
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Dates
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Enumeration Date | 02/05/2007
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Last Update Date | 04/20/2008
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Provider Practice Location Address
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Address Line | 908 WASHINGTON ST
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City | HUNTINGDON
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State | PA
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Zip | 16652-1826
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Country | US
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Telephone | 814-643-5565
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Fax | 814-643-2607
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Provider Business Mailing Address
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Address Line | 908 WASHINGTON ST
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City | HUNTINGDON
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State | PA
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Zip | 16652-1826
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Country | US
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Telephone | 814-643-5565
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Fax | 814-643-2607
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Authorized Official
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Title or Position | OWNER
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Name | DR. BRIAN J HOOVER
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Credential | DPM
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Telephone | 814-643-5193
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0131X
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Taxonomy Name | Foot Surgery Podiatrist
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License Number | SC001976-L
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License Number State | PA
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