NPI | 1154747400 |
---|---|
Entity Type | Organization |
Authorized Contact | SHRON BROOKS Sole Podiatrist 618-293-1785 |
Organization Subpart ? | No |
Primary Taxonomy | 261QP1100X Clinic/Center, Podiatric (Licence: IL 016004697) |
Enumeration Date | 2014-03-11 |
Last Update Date | 2014-03-11 |