| NPI | 1356462303 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONNA L COLLINS Administrator 757-436-5824 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: VA 0103000785) |
| Enumeration Date | 2007-04-03 |
| Last Update Date | 2008-03-27 |