| NPI | 1114142973 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES JOHN ZIMMERMANN Physician 859-236-5140 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: KY KY206) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: KY 00206) |
| 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment (Licence: KY 00206) | |
| Enumeration Date | 2007-04-16 |
| Last Update Date | 2008-11-05 |