| NPI | 1073524088 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT WALTER SULLIVAN President 757-363-3338 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist Foot & Ankle Surgery (Licence: VA 0103000735) |
| Enumeration Date | 2006-08-11 |
| Last Update Date | 2021-07-29 |