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Organization
PENNDOC FOOT & ANKLE CENTER, LLC
Active
Organization
PENNDOC FOOT & ANKLE CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HOLLY FOOT EAKIN (OFFICE BILLER)
(181) 436-2366
Entity
Organization
Contact information
Practice address
133 MILL ST, BRADFORD, PA 16701-1408
(814) 362-3668
(814) 362-0540
Mailing address
PO BOX 40, BRADFORD, PA 16701-0040
(814) 362-3668
(814) 362-0540
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
SC003540L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0012260110001
—
PA
Enumeration date
08/28/2007
Last updated
12/22/2020
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