| NPI | 1275693509 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK MICELI Owner 704-547-0000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: NC 302) |
| Enumeration Date | 2006-12-08 |
| Last Update Date | 2008-02-14 |