Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Primary Podiatric Medicine |
213EP1101X | 48 | Podiatry |
| NPI # | 1982930160 |
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| LBN Legal business name | SYNERGY WELLNESS CENTER LLC | ||||||||
| Authorized official | GLORIA GERSTNER - (PHYSICIAN) | ||||||||
| Entity | Organization | ||||||||
| Organization subpart 1 | No | ||||||||
| Enumeration date | 10/23/2009 | ||||||||
| Last updated | 09/24/2010 - About 16 years ago | ||||||||
| Identifiers |
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SYNERGY WELLNESS CENTER LLC
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| JUDITH S SCHNEIDER, L.I.S.W. 21074A HIGHWAY 84 ABIQUIÚ, NM |
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