Individual
ELISA FAULK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.P.M.
Contact information
Practice address
737 MAIN ST, SUITE 6, LUMBERTON, NJ 08048-3089
(609) 267-9400
Mailing address
P.O.BOX 331, WAUCHULA, FL 33873
(813) 760-2386
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
#25MD00309700
NJ
Other
Enumeration date
06/08/2011
Last updated
08/07/2017
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