| NPI | 1285880005 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY MARIE MOXLEY Surgical Podiatrist 907-789-0405 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP1100X Clinic/Center Podiatric (Licence: AK 6398) |
| Enumeration Date | 2008-08-12 |
| Last Update Date | 2008-10-24 |