Organization Name: | TOUSSAINT PODIATRY CLINIC, LLC |
NPI Number: | 1235480161 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | CORBETT ELIZABETH TOUSSAINT (OWNER) |
Mailing Address: | 600 N Wheeler Ave Prosperity |
State: | SC US |
Postal Code: | 291279332 |
Phone Number: | 3123396498 |
Fax Number: | |
NPI Enumeration Date: | 10/02/2012 |
NPI Last Update Date: | 12/21/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 213ES0103X |
License Number: | 619 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | SC |
Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
Taxonomy Classification: | Podiatrist |
Taxonomy Specialization: | Foot & Ankle Surgery |
Taxonomy Definition: |