| NPI | 1053316802 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURENCE CLARKE ROGERS Administrator/Owner 574-224-7500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP1100X Clinic/Center, Podiatric (Licence: IN 008092) |
| Enumeration Date | 2005-06-17 |
| Last Update Date | 2020-08-22 |