| NPI | 1053320580 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOUGLAS H HALLGREN President 301-862-3338 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: N/A) |
| Additional Taxonomies | 332900000X Non-Pharmacy Dispensing Site (Licence: MD 01346) |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2023-05-17 |