Organization
HEALTH PARK PODIATRIC FOOT AND ANKLE CLINIC, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LAURIE J LOVE (MANAGER)
(904) 825-0046
Entity
Organization
Contact information
Practice address
1975 OLD MOULTRIE RD, ST AUGUSTINE, FL 32086-5164
(904) 825-0046
Mailing address
1975 OLD MOULTRIE RD, ST AUGUSTINE, FL 32086-5164
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
—
—
Other
Enumeration date
01/20/2010
Last updated
08/13/2010
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