Organization Name: | INSTRIDE FOOT AND ANKLE SPECIALISTS, PLLC |
NPI Number: | 1144692658 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | BRANDON S PERCIVAL (AUTHORIZED OFFICIAL) |
Mailing Address: | 2845 E Highway 76 Mullins |
State: | SC US |
Postal Code: | 295746037 |
Phone Number: | 8434312780 |
Fax Number: | |
NPI Enumeration Date: | 10/23/2015 |
NPI Last Update Date: | 10/23/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 213ES0103X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
Taxonomy Classification: | Podiatrist |
Taxonomy Specialization: | Foot & Ankle Surgery |
Taxonomy Definition: |