| NPI | 1134162910 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN J LARSEN President 308-381-0404 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213E00000X Podiatrist |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2006-06-13 |
| Last Update Date | 2022-07-21 |