| NPI | 1013417419 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN E MOORE President/Podiatrist 606-679-2773 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery |
| 363LF0000X Nurse Practitioner, Family | |
| Enumeration Date | 2018-02-13 |
| Last Update Date | 2021-03-04 |