Organization Name: | MARI WARGO-DORSEY, DPM |
NPI Number: | 1417313644 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MARI WARGO-DORSEY (PODIATRIST) |
Mailing Address: | 201 Auen Rd Saltsburg |
State: | PA US |
Postal Code: | 156818119 |
Phone Number: | 7244224199 |
Fax Number: | |
NPI Enumeration Date: | 01/04/2016 |
NPI Last Update Date: | 01/04/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 213ES0103X |
License Number: | SC006043 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
Taxonomy Classification: | Podiatrist |
Taxonomy Specialization: | Foot & Ankle Surgery |
Taxonomy Definition: |