Brush Mountain Shoe

NPI 1366476608 - Podiatrist - 213E00000X

NPI Details
NPI 1366476608
Enumeration Date 07/11/2006
Last Updated 05/21/2008
Entity Type Healthcare Provider
Active Over 10 years ago
Authorized Information
Name CHARLES WAYNE CHARLES
Position SECRETARY
Phone (814) 941-2132
Fax (814) 941-4491
Practice Location
3415 PLEASANT VALLEY BLVD
ALTOONA PA, 16602-4321, US
Phone (814) 941-2132
Fax (814) 941-4491
Business Location
3415 PLEASANT VALLEY BLVD
ALTOONA PA, 16602-4321, US
Phone (814) 941-2132
Fax (814) 941-4491
Toxanomy
Taxonomy Code 213E00000X
License State Pennsylvania
License Number BCP9905
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According to our database, Brush Mountain Shoe NPI is 1366476608, taxonomy code is 213E00000X and license number is BCP9905, license state is located at Pennsylvania. Brush Mountain Shoe physically located at 3415 Pleasant Valley Blvd, Altoona PA, 16602-4321. NPI Number 1033115704 has the healthcare provider type.

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1366476608 NPI number is provided on an as is basis without warranty of any kind. 1366476608 is maintained by the National Plan & Provider Enumeration System. The contents of Brush Mountain Shoe are for informational purposes only.