| NPI | 1255356713 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHLEEN M. MCGEE Office Manager 757-523-0414 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: VA 0103000759) |
| Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: VA 0103000759) |
| 213ES0131X (Licence: VA 0103000759) | |
| 213EP1101X Podiatrist, Primary Podiatric Medicine (Licence: VA 0103000759) | |
| 213ER0200X Podiatrist, Radiology (Licence: VA 0103000759) | |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2017-04-27 |