| NPI | 1003962432 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSE N. ANDERSON President 757-625-2962 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2007-01-26 |
| Last Update Date | 2011-08-19 |