| NPI | 1235132861 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROGER PORTER Dpm Owner 859-635-6666 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: KY 239) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: KY 239) |
| Enumeration Date | 2005-05-27 |
| Last Update Date | 2016-03-22 |