| NPI | 1003099441 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BENNY FAIR Owner 260-458-9953 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213EP1101X Podiatrist, Primary Podiatric Medicine (Licence: IN 07000728) |
| Enumeration Date | 2007-12-07 |
| Last Update Date | 2007-12-07 |