| NPI | 1033202957 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN ANDREW PETERY President 336-218-8490 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213EP1101X Podiatrist, Primary Podiatric Medicine (Licence: NC 297) |
| Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: NC 297) |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2019-02-19 |