| NPI | 1295110013 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLI CLARKSON Office Manager 410-758-5446 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery |
| Additional Taxonomies | 261QP1100X Clinic/Center, Podiatric |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment | |
| Enumeration Date | 2015-07-22 |
| Last Update Date | 2024-12-27 |