Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Surgery, Foot & Ankle |
213ES0103X | 48 | Podiatry | |
Podiatric |
261QP1100X |
| NPI Number | 1992240865 |
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| LBN Legal business name | COHO FOOT & ANKLE, PS | ||||
| Authorized official | DEKKER MCKEEVER - (PRESIDENT) | ||||
| Entity | Organization | ||||
| Organization subpart 1 | No | ||||
| Enumeration date | 12/30/2016 | ||||
| Last updated | 10/03/2018 - About 8 years ago | ||||
| Identifiers |
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