Organization
NORTH EAST FOOT CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MORGAN TIMOTHY HOLMES D.P.M. (OWNER)
(814) 725-2715
Entity
Organization
Contact information
Practice address
90 E MAIN ST, SUITE 3, NORTH EAST, PA 16428-1319
(814) 725-2715
(814) 725-5186
Mailing address
90 E MAIN ST, SUITE 3, NORTH EAST, PA 16428-1319
(814) 725-2715
(814) 725-5186
Taxonomy
Speciality
Code
Description
License number
State
213ES0131X
Foot Surgery Podiatrist
Primary
SC003377L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0012954200006
—
PA
Enumeration date
05/11/2007
Last updated
08/22/2020
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