Organization
PANHANDLE PODIATRY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER FALLON MOLLICA (OFFICE MANAGER)
(304) 267-3030
Entity
Organization
Contact information
Practice address
489 MID ATLANTIC PARKWAY, SUITE 1, MARTINSBURG, WV 25404-3594
(304) 267-3030
(304) 267-0660
Mailing address
PO BOX 1961, MARTINSBURG, WV 25402-1961
(304) 267-3030
(304) 267-0660
Taxonomy
Speciality
Code
Description
License number
State
213EP1101X
Primary Podiatric Medicine Podiatrist
Primary
WV00358
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2102009000
—
WV
Enumeration date
10/26/2007
Last updated
03/04/2016
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