| NPI | 1013319961 |
|---|---|
| Doing Business As | PODIATRY CLINIC |
| Entity Type | Organization |
| Authorized Contact | JUDY H. HOLT Office Adm./Office Mgr 731-427-5581 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213EP1101X Podiatrist, Primary Podiatric Medicine |
| Additional Taxonomies | 213E00000X Podiatrist |
| 213ER0200X Podiatrist, Radiology | |
| 213ES0131X Podiatrist, Foot Surgery | |
| Enumeration Date | 2014-09-23 |
| Last Update Date | 2015-03-17 |