| NPI | 1043518913 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRUCE P THEALL Owner/Medical Director 973-673-3668 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2011-03-02 |
| Last Update Date | 2013-12-10 |