| NPI | 1265935977 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TREVECCA SHAW Podiatrist/Owner 216-798-6731 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: KY 00338) |
| Enumeration Date | 2018-03-09 |
| Last Update Date | 2018-07-19 |