| NPI | 1023272226 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRAIG R LANE Podiatric 410-523-5898 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP1100X Clinic/Center, Podiatric |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2008-07-16 |
| Last Update Date | 2011-06-07 |