# SUSQUEHANNA VALLEY FOOT AND ANKLE CENTER, INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1578627626
- **Authorized official:** DARLA R MILLER DPM (PHYSICIAN, PRESIDENT)
- **Authorized official phone:** (570) 374-3668

## Contact information

- **Practice address:** 3120 N OLD TRL STE A, SHAMOKIN DAM, PA 17876-9428
- **Practice address phone:** (570) 374-3668
- **Practice address fax:** (570) 374-7306
- **Mailing address:** 3120 N OLD TRL STE A, SHAMOKIN DAM, PA 17876-9428
- **Mailing address phone:** (570) 374-3668
- **Mailing address fax:** (570) 374-7306

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | SC004004L | PA | Yes |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | SC004206R | PA | — |

## Other

- **Enumeration date:** 12/21/2006
- **Last updated:** 05/26/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0015721370004 | — | PA |
| 05 | — | 0015896440005 | — | PA |