| 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 | 2025-11-18 |