| NPI | 1164705174 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUTH SKIDMORE Cheif Executive Officer 707-573-6933 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213E00000X Podiatrist |
| Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery |
| Enumeration Date | 2011-09-26 |
| Last Update Date | 2012-03-01 |