| NPI | 1265968929 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENA CLAY Office Manager 904-384-2240 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist |
| Additional Taxonomies | 213EP1101X Podiatrist, Primary Podiatric Medicine |
| Enumeration Date | 2017-05-02 |
| Last Update Date | 2017-05-02 |