| NPI | 1063697639 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRUCE TODD FOX President 301-589-7663 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP1100X Clinic/Center, Podiatric (Licence: MD 01336) |
| Additional Taxonomies | 335E00000X Prosthetic/Orthotic Supplier (Licence: MD 01336) |
| Enumeration Date | 2008-01-02 |
| Last Update Date | 2008-01-02 |