Organization
GARDEN STATE FOOT CARE
Active
Organization
GARDEN STATE FOOT CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LARRY L. LODGE DPM (OWNER)
(856) 753-1300
Entity
Organization
Contact information
Practice address
200 B STATE HIGHWAY 73, SUITE 3, VOORHEES, NJ 08043-9542
(856) 753-1300
(856) 768-2965
Mailing address
200 B STATE HIGHWAY 73, SUITE 3, VOORHEES, NJ 08043-9542
(856) 753-1300
(856) 768-2965
Taxonomy
Speciality
Code
Description
License number
State
213ES0131X
Foot Surgery Podiatrist
Primary
25MD002054
NJ
Other
Enumeration date
05/08/2008
Last updated
10/15/2009
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