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General NPI Number Information
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NPI Number | 1952405979
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Entity Type | Organization
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Legal Business Name | SCITUATE PODIATRY GROUP INC
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Dates
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Enumeration Date | 09/11/2006
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Last Update Date | 07/10/2018
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Provider Practice Location Address
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Address Line | 541 MAIN ST SUITE 105
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City | WEYMOUTH
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State | MA
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Zip | 02190
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Country | US
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Telephone | 781-337-3334
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Fax | 781-331-2197
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Provider Business Mailing Address
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Address Line | 10 NEW DRIFTWAY SUITE 103
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City | SCITUATE
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State | MA
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Zip | 02066-4546
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Country | US
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Telephone | 781-545-9285
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Fax | 781-545-9553
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Authorized Official
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Title or Position | PROVIDER/OWNER
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Name | DR. GARY W COUNT
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Credential | DPM
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Telephone | 781-545-9285
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 001515
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License Number State | MA
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