NPI | 1255213997 |
---|---|
Entity Type | Organization |
Authorized Contact | KIYA BOYCE Regional Credentialing Specialist 301-933-7133 |
Organization Subpart ? | No |
Primary Taxonomy | 213E00000X Podiatrist |
Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
213ES0103X Podiatrist, Foot & Ankle Surgery | |
Enumeration Date | 2025-07-23 |
Last Update Date | 2025-07-23 |