| NPI | 1063630291 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK L SIMCHUK Excutive Officer 541-471-7056 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist Foot & Ankle Surgery (Licence: OR DP00291) |
| Enumeration Date | 2007-04-23 |
| Last Update Date | 2009-08-21 |