| NPI | 1174069603 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEREK T PANTIEL President 440-623-1221 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist Foot & Ankle Surgery (Licence: NC 606) |
| Enumeration Date | 2017-01-08 |
| Last Update Date | 2017-01-08 |