| NPI | 1295788354 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH J MORAN Owner 803-376-1717 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0131X Podiatrist Foot Surgery (Licence: SC 00151) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: SC 00151) |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2012-12-12 |