| NPI | 1053853044 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DALE SCHMIDT Secretary 888-290-6321 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 207N00000X Dermatology |
| 213EP1101X Podiatrist, Primary Podiatric Medicine | |
| Enumeration Date | 2016-11-08 |
| Last Update Date | 2016-11-28 |