| NPI | 1134466113 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN C MCDONALD President 704-886-1918 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213EP1101X Podiatrist, Primary Podiatric Medicine (Licence: NC 276) |
| Additional Taxonomies | 213ES0131X (Licence: NC 276) |
| 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: NC 276) | |
| Enumeration Date | 2013-01-10 |
| Last Update Date | 2016-03-11 |