| NPI | 1275735086 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DUSKY RIDEOUT FARMER Owner 812-421-8555 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0131X Podiatrist Foot Surgery (Licence: IN 07000944A) |
| Enumeration Date | 2007-06-04 |
| Last Update Date | 2008-03-17 |