Organization Name: | PODIATRIC MEDICAL SERVICES FOR AMBULATORY SERVICES PLLC |
NPI Number: | 1164545950 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | IAN KEITH COOK (MEMBER) |
Mailing Address: | 4100 Sion Farm Suite 7 St. Croix |
State: | VI US |
Postal Code: | 00820 |
Phone Number: | 3407138397 |
Fax Number: | 3407195301 |
NPI Enumeration Date: | 04/09/2007 |
NPI Last Update Date: | 08/14/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QA1903X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Ambulatory Surgical |
Taxonomy Definition: |