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 |