NPI | 1366086886 |
---|---|
Entity Type | Organization |
Authorized Contact | JESSE MONIZ Director Of Enrollment 800-841-5200 |
Organization Subpart ? | No |
Primary Taxonomy | 213E00000X Podiatrist |
Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
Enumeration Date | 2019-10-29 |
Last Update Date | 2021-12-14 |