| NPI | 1346906609 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NITIE I SROA Dpm 419-799-1180 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 213E00000X Podiatrist |
| Enumeration Date | 2021-11-11 |
| Last Update Date | 2021-11-12 |