Organization · Type 2 NPI
Bridgewater Goddard Park Medical Associates Podiatry Division
Foot Surgery Podiatrist · Brockton, MA
NPI number
1962686329
Active
Practice location
110 Liberty St
Brockton, MA 02301-5521
Fax (508) 565-0157
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Foot Surgery Podiatrist Primary | 213ES0131X | 1715 (MA) |
Foot Surgery Podiatrist: Definition to come...
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About NPI 1962686329
Bridgewater Goddard Park Medical Associates Podiatry Division's National Provider Identifier is 1962686329, issued on Dec 20, 2007. The primary taxonomy on file is Foot Surgery Podiatrist (213ES0131X), and the practice location is in Brockton, MA. The record was last updated on May 23, 2012.