| NPI | 1093094088 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID G. SANDERSON Owner 814-834-7240 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP1100X Clinic/Center Podiatric (Licence: PA SC004253L) |
| Enumeration Date | 2011-08-09 |
| Last Update Date | 2011-08-09 |