| NPI | 1164751418 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRUCE G BLANK Owner 740-695-4188 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: OH 36-00-2569-B) |
| Enumeration Date | 2009-12-16 |
| Last Update Date | 2009-12-16 |