| NPI | 1144980517 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALEXANDER REYZELMAN Rcmo 415-292-0638 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 213ES0000X Podiatrist, Sports Medicine |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2021-12-27 |
| Last Update Date | 2024-08-01 |