| NPI | 1033250055 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICKIE LYNN SCHULTHEISS Office Manager 410-836-0131 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP1100X Clinic/Center Podiatric (Licence: MD A1308) |
| Enumeration Date | 2007-02-11 |
| Last Update Date | 2011-06-02 |