| NPI | 1043399439 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD MARC JACOBS Owner/President 301-779-0355 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP1100X Clinic/Center, Podiatric (Licence: MD 952) |
| Enumeration Date | 2006-11-04 |
| Last Update Date | 2007-12-07 |