| NPI | 1063782472 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAN PHILIP CONRAD President 605-348-6180 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP1100X Clinic/Center, Podiatric (Licence: SD 142) |
| Enumeration Date | 2012-01-03 |
| Last Update Date | 2012-01-26 |