| NPI | 1336310341 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHY BEAUCHAMP Office Manager 660-385-4464 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213EP1101X Podiatrist, Primary Podiatric Medicine |
| Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery |
| Enumeration Date | 2008-03-18 |
| Last Update Date | 2013-01-22 |