Organization
COTTAGE LAKE PODIATRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROGER PATRICK TRAVIS DPM (OWNER)
(434) 432-8417
Entity
Organization
Contact information
Practice address
148 FRANCIS RD, JAVA, VA 24565-2000
(434) 432-8417
Mailing address
148 FRANCIS RD, JAVA, VA 24565-2000
(434) 432-8417
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
0103300987
VA
Other
Enumeration date
09/28/2010
Last updated
09/28/2010
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