| NPI | 1205569100 |
|---|---|
| Former Legal Business Name | ADVANCED FOOT AND ANKLE CENTER |
| Entity Type | Organization |
| Authorized Contact | SCOTT A CLARK Dpm 801-505-5277 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QP1100X Clinic/Center, Podiatric |
| Enumeration Date | 2022-07-07 |
| Last Update Date | 2022-07-07 |