Cottage Lake Podiatry

Organization Active NPI Podiatrist · Java, VA

NPI 1568771384 · NPPES record last updated Sep 28, 2010

Key facts

NPI
1568771384
Entity type
Organization (NPI type 2)
Primary specialty
Podiatrist 213E00000X
License
0103300987 (VA)
Legal business name
COTTAGE LAKE PODIATRY
Practice address
148 Francis Rd
Java, VA 24565-2000
Phone
(434) 432-8417
NPI assigned
Sep 28, 2010
Organization subpart
No

Authorized official

Name
Roger Patrick Travis, DPM
Title
Owner
Phone
(434) 432-8417

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist
Group: 193400000X SINGLE SPECIALTY GROUP
213E00000X 0103300987 VA Yes

Addresses

Primary practice location

148 Francis Rd
Java, VA 24565-2000

Mailing address

148 Francis Rd
Java, VA 24565-2000
Phone (434) 432-8417

Other providers in Java, VA

All providers in Java, VA · Podiatrist in Virginia

Sources for this page

Verify at the official NPI Registry.