| NPI | 1164722807 |
|---|---|
| Doing Business As | JACKSON FOOT AND ANKLE CLINIC |
| Entity Type | Organization |
| Authorized Contact | DEBBIE BREWER Director 877-892-9813 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| Enumeration Date | 2010-10-28 |
| Last Update Date | 2012-05-17 |