| NPI | 1356958276 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUSSELL SCOTT GRIMES Dpm 816-364-2338 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2020-09-24 |
| Last Update Date | 2025-01-14 |