Organization Name: | CARBON PODIATRY ASSOCIATES, INC. |
NPI Number: | 1205939378 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MATTHEW OWEN MERTZ (VICE PRESIDENT) |
Mailing Address: | 181 S 2nd St Lehighton |
State: | PA US |
Postal Code: | 182352054 |
Phone Number: | 6103772490 |
Fax Number: | 6103779201 |
NPI Enumeration Date: | 09/06/2006 |
NPI Last Update Date: | 06/30/2008 |
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: |