| NPI | 1316077209 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLI JEANE RUDDLE Office Manager 636-532-3131 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: MO 000552) |
| Enumeration Date | 2007-03-07 |
| Last Update Date | 2011-11-18 |