| NPI | 1235648049 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JARED CHARLES SHIPPEE Owner, COO, CFO 435-200-5756 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0131X Podiatrist, Foot Surgery (Licence: UT 373091-0501) |
| Enumeration Date | 2017-09-25 |
| Last Update Date | 2022-07-21 |