Organization
BANGOR PODIATRY LLC
Active
Parent organization
BANGOR PODIATRY LLC
Other names
Bangor Podiatry of Brodheadsville
Organization subpart
Yes
Provider details
NPI number
Legal business name
BANGOR PODIATRY LLC
Authorized official
CHERALYN PERKINS DPM (OWNER)
(610) 588-6621
Entity
Organization
Contact information
Practice address
1310 ROUTE 209 STE 107, GILBERT, PA 18331-7751
(570) 992-5779
(570) 992-5806
Mailing address
129 N 11TH ST, BANGOR, PA 18013-1603
(610) 588-6621
(610) 588-6307
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
SC004468L
PA
Other
Enumeration date
03/12/2015
Last updated
11/15/2024
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