| NPI | 1295266641 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN CHARLES MCDONALD President 704-786-4482 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213EP1101X Podiatrist Primary Podiatric Medicine (Licence: NC 606) |
| Additional Taxonomies | 213ES0131X Podiatrist Foot Surgery (Licence: NC 606) |
| Enumeration Date | 2017-03-27 |
| Last Update Date | 2022-06-03 |