| NPI | 1023294808 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH L. WICHMAN Podiatrist 860-649-3338 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2008-01-11 |
| Last Update Date | 2011-04-15 |