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Individual

MATILDA TOWNSEND

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
D.P.M.

Contact information

Practice address
2550 PARK ST, JACKSONVILLE, FL 32204-4518
(904) 387-1403
Mailing address
2550 PARK ST, JACKSONVILLE, FL 32204-4518
(904) 387-1403

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
PO 3443
FL
213EP1101X
Primary Podiatric Medicine Podiatrist
PO 3443
FL
213ES0131X
Foot Surgery Podiatrist
PO 3443
FL

Other

Enumeration date
08/19/2010
Last updated
08/19/2010
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