NPI | 1073178075 |
---|---|
Entity Type | Organization |
Authorized Contact | SHUNN PHILLIPS CFO 225-769-4044 |
Organization Subpart ? | Yes |
Primary Taxonomy | 213E00000X Podiatrist |
Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery |
261Q00000X | |
Enumeration Date | 2019-05-06 |
Last Update Date | 2019-05-06 |