| NPI | 1184137762 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BLAKE HINES Podiatrist/Owner 417-389-2203 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: CO POD.0000803) |
| Enumeration Date | 2017-11-06 |
| Last Update Date | 2017-12-27 |