| NPI | 1043088966 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD PAUL JACOBY Owner/CEO 480-994-5977 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 213EP1101X Podiatrist Primary Podiatric Medicine |
| Enumeration Date | 2023-12-20 |
| Last Update Date | 2023-12-20 |