| NPI | 1144401704 |
|---|---|
| Doing Business As | ANKLE & FOOT SPECIALIST OF BONNEY LAKE |
| Entity Type | Organization |
| Authorized Contact | TINA M QUEVEDO Billing Office Supervisor 253-841-2006 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 213ES0103X Podiatrist Foot & Ankle Surgery |
| Enumeration Date | 2007-11-23 |
| Last Update Date | 2008-06-05 |