Organization Name: | WALTER S BUCK 3RD DPM LLC |
NPI Number: | 1073873204 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | WALTER S BUCK (OWNER) |
Mailing Address: | 1401 N 5th St Perkasie |
State: | PA US |
Postal Code: | 189442204 |
Phone Number: | 2152576315 |
Fax Number: | |
NPI Enumeration Date: | 05/22/2012 |
NPI Last Update Date: | 05/22/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 213ES0103X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
Taxonomy Classification: | Podiatrist |
Taxonomy Specialization: | Foot & Ankle Surgery |
Taxonomy Definition: |