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Organization
PORTONOVA FOOT AND ANKLE SPECIALISTS LLC
Active
Organization
PORTONOVA FOOT AND ANKLE SPECIALISTS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID J PORTONOVA D.P.M. (OWNER)
(570) 387-2202
Entity
Organization
Contact information
Practice address
6850 LOWS RD STE 316, BLOOMSBURG, PA 17815-8708
(570) 387-2202
(570) 387-2203
Mailing address
PO BOX 1935, KINGSTON, PA 18704-0935
(570) 288-8881
(570) 288-8065
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
SC006404
PA
Other
Enumeration date
06/12/2015
Last updated
09/17/2021
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