# BANGOR PODIATRY LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** BANGOR PODIATRY LLC
- **Other names:** Bangor Podiatry of Brodheadsville
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1972996189
- **Legal business name:** BANGOR PODIATRY LLC
- **Authorized official:** CHERALYN PERKINS DPM (OWNER)
- **Authorized official phone:** (610) 588-6621

## Contact information

- **Practice address:** 1310 ROUTE 209 STE 107, GILBERT, PA 18331-7751
- **Practice address phone:** (570) 992-5779
- **Practice address fax:** (570) 992-5806
- **Mailing address:** 129 N 11TH ST, BANGOR, PA 18013-1603
- **Mailing address phone:** (610) 588-6621
- **Mailing address fax:** (610) 588-6307

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | SC004468L | PA | Yes |

## Other

- **Enumeration date:** 03/12/2015
- **Last updated:** 11/15/2024