Organization Name: | JAMES N. PACE |
NPI Number: | 1114255262 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JAMES NICHOLAS PACE (OWNER) |
Mailing Address: | 916 Penn Ave Wyomissing |
State: | PA US |
Postal Code: | 196103017 |
Phone Number: | 6103765649 |
Fax Number: | 6103764194 |
NPI Enumeration Date: | 12/01/2009 |
NPI Last Update Date: | 12/01/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 213EP1101X |
License Number: | SC002934L |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
Taxonomy Classification: | Podiatrist |
Taxonomy Specialization: | Primary Podiatric Medicine |
Taxonomy Definition: |