NPI | 1235168311 |
---|---|
Former Legal Business Name | ARK LA TEX FOOT SPECIALISTS, LLC |
Entity Type | Organization |
Authorized Contact | GREGORY W. BRYAN Owner/Manager 318-687-8447 |
Organization Subpart ? | No |
Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: LA PD067R / PD207R) |
Enumeration Date | 2006-07-01 |
Last Update Date | 2020-02-27 |