| NPI | 1336564749 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SARA BORKOSKY Owner 864-934-8396 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0131X (Licence: SC 631) |
| Additional Taxonomies | 213EP1101X Podiatrist, Primary Podiatric Medicine (Licence: SC 631) |
| Enumeration Date | 2014-02-21 |
| Last Update Date | 2016-10-24 |