| NPI | 1053819904 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN E MOORE President/Podiatrist 606-679-2773 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0131X Podiatrist, Foot Surgery |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery |
| 363LF0000X Nurse Practitioner, Family | |
| Enumeration Date | 2018-01-25 |
| Last Update Date | 2018-01-25 |