| Organization Name: | OAK TREE PODIATRY, INC |
| NPI Number: | 1336564749 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | SARA BORKOSKY (OWNER) |
| Mailing Address: | 5 Winchester Ct Mauldin |
| State: | SC US |
| Postal Code: | 296622626 |
| Phone Number: | 8649348396 |
| Fax Number: | |
| NPI Enumeration Date: | 02/21/2014 |
| NPI Last Update Date: | 07/28/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 213EP1101X |
| License Number: | 631 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | SC |
| Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
| Taxonomy Classification: | Podiatrist |
| Taxonomy Specialization: | Primary Podiatric Medicine |
| Taxonomy Definition: | |