| NPI | 1154684819 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TARA L.F. BLASINGAME President 256-232-2009 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0131X Podiatrist, Foot Surgery (Licence: AL 164) |
| Additional Taxonomies | 261QP1100X Clinic/Center, Podiatric |
| Enumeration Date | 2012-06-18 |
| Last Update Date | 2020-04-19 |