Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213E00000X | Podiatrist | OH000066 | PA |
N | 222Z00000X | Podiatrist | OH000066 | PA |
Y | 224P00000X | Prosthetist | PO000034 | PA |
NPI | 1285121889 |
---|---|
Provider Name | Eugene Flenner JR. |
First Address | Greensburg, PA 15601 |
Second Address | Greensburg, PA 15601 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/04/2018 |
Last Update Date | 18/04/2018 |