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General NPI Number Information
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NPI Number | 1871860106
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Entity Type | Organization
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Legal Business Name | LADHA PSC
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Dates
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Enumeration Date | 12/01/2011
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Last Update Date | 01/18/2012
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Provider Practice Location Address
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Address Line | 3605 NORTHGATE CT SUITE 206
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City | NEW ALBANY
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State | IN
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Zip | 47150-6400
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Country | US
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Telephone | 812-945-9221
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Fax | 812-945-7141
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Provider Business Mailing Address
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Address Line | 3605 NORTHGATE CT SUITE 206
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City | NEW ALBANY
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State | IN
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Zip | 47150-6400
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Country | US
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Telephone | 812-945-9221
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Fax | 812-945-7141
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | TRESSEA R HARVEY
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Credential |
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Telephone | 812-945-9221
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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 |
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License Number State |
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