Organization Name: | EDWARD A. CLINE, DPM, PC |
NPI Number: | 1164543591 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | EDWARD A CLINE (PODIATRIST OWNER) |
Mailing Address: | 109 Virginia St Suite 278 Hannibal |
State: | MO US |
Postal Code: | 634013778 |
Phone Number: | 5732213266 |
Fax Number: | 5732218066 |
NPI Enumeration Date: | 04/03/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 213ES0103X |
License Number: | 0000745 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MO |
Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
Taxonomy Classification: | Podiatrist |
Taxonomy Specialization: | Foot & Ankle Surgery |
Taxonomy Definition: |