| NPI | 1285322735 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | APRIL WHITE Gm 815-846-1351 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery |
| Additional Taxonomies | 213E00000X Podiatrist |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2023-04-24 |
| Last Update Date | 2024-05-02 |