| NPI | 1295992873 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK J EDMUNDS President 270-885-1203 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213E00000X Podiatrist |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: KY 00294) |
| Enumeration Date | 2008-05-21 |
| Last Update Date | 2016-03-22 |