| NPI | 1003579178 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEANNIE M BASKIN Corporate Administrator 904-251-5053 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery |
| Enumeration Date | 2021-10-15 |
| Last Update Date | 2023-06-01 |