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Organization
SUSQUEHANNA VALLEY FOOT AND ANKLE CENTER, INC
Active
Organization
SUSQUEHANNA VALLEY FOOT AND ANKLE CENTER, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DARLA R MILLER DPM (PHYSICIAN, PRESIDENT)
(570) 374-3668
Entity
Organization
Contact information
Practice address
3120 N OLD TRL STE A, SHAMOKIN DAM, PA 17876-9428
(570) 374-3668
(570) 374-7306
Mailing address
3120 N OLD TRL STE A, SHAMOKIN DAM, PA 17876-9428
(570) 374-3668
(570) 374-7306
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
SC004004L
PA
213ES0103X
Foot & Ankle Surgery Podiatrist
SC004206R
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0015721370004
—
PA
05
—
0015896440005
—
PA
Enumeration date
12/21/2006
Last updated
05/26/2023
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