| NPI | 1174020549 |
|---|---|
| Doing Business As | SOLE SOURCE PODIATRY |
| Entity Type | Organization |
| Authorized Contact | BRADLEY R HAMMERSLEY Owner 765-244-7440 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0131X Podiatrist, Foot Surgery (Licence: IN 07000906A) |
| Enumeration Date | 2018-04-11 |
| Last Update Date | 2018-04-11 |