Provider Demographics
NPI:1134317555
Name:MJ6 ENTERPRISES
Entity type:Organization
Organization Name:MJ6 ENTERPRISES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:E
Authorized Official - Last Name:WINTERSTEEN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:484-824-2405
Mailing Address - Street 1:51 GOLDFINCH CIR
Mailing Address - Street 2:
Mailing Address - City:PHOENIXVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19460-1001
Mailing Address - Country:US
Mailing Address - Phone:484-824-2405
Mailing Address - Fax:
Practice Address - Street 1:996 E ORANGE ST
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17602-3214
Practice Address - Country:US
Practice Address - Phone:717-295-5550
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-10
Last Update Date:2007-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC00446R213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty