| NPI | 1295264224 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TROY ADAM HARRIS Manager 904-707-8769 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: FL po3922) |
| Enumeration Date | 2017-06-04 |
| Last Update Date | 2022-07-21 |