| NPI | 1265601876 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT DARRIN HURST Owner 662-286-1406 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: MS 80185) |
| Enumeration Date | 2008-02-27 |
| Last Update Date | 2019-11-04 |