| NPI | 1144262718 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SEAN ROBERT STODDARD Owner 732-580-0566 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: NJ 25MD00268500) |
| Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery |
| Enumeration Date | 2006-06-11 |
| Last Update Date | 2008-06-25 |