| NPI | 1104154863 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRADLEY R HAMMERSLEY Doctor/Owner 765-473-4220 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: IN 07000906A) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: IN 07000906A) |
| Enumeration Date | 2009-11-18 |
| Last Update Date | 2010-10-05 |