| NPI | 1154341592 |
|---|---|
| Doing Business As | MOBERLY FOOT CLINIC |
| Entity Type | Organization |
| Authorized Contact | JONATHON LEE FALLIS Owner 660-263-6677 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: IL 016004851) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: MO 2002006341) |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2008-04-20 |