| NPI | 1306984117 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELO PAUL MORREALE Podiatric Physician Owner 318-797-3668 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213E00000X Podiatrist |
| Additional Taxonomies | 213ER0200X Podiatrist Radiology |
| 213EP1101X Podiatrist Primary Podiatric Medicine | |
| 213ES0000X Podiatrist Sports Medicine | |
| 213ES0103X Podiatrist Foot & Ankle Surgery | |
| 213ES0131X Podiatrist Foot Surgery | |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| 332BC3200X Durable Medical Equipment & Medical Supplies Customized Equipment | |
| 335E00000X Prosthetic/Orthotic Supplier | |
| Enumeration Date | 2007-02-02 |
| Last Update Date | 2016-10-06 |