Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Surgery, Foot & Ankle |
213ES0103X | 48 | Podiatry |
| NPI Number | 1316046790 |
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| LBN Legal business name | MATT A. HEILALA, DPM INC. | ||||||||||||||||
| Authorized official | MATT HEILALA - (PRESIDENT) | ||||||||||||||||
| Entity | Organization | ||||||||||||||||
| Organization subpart 1 | No | ||||||||||||||||
| Enumeration date | 09/21/2006 | ||||||||||||||||
| Last updated | 08/22/2020 - About 6 years ago | ||||||||||||||||
| Identifiers |
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