| NPI | 1205054442 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON T WHITE Owner 716-434-6601 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: NY 005864) |
| Additional Taxonomies | 305S00000X Point of Service |
| Enumeration Date | 2007-04-23 |
| Last Update Date | 2023-03-28 |