| NPI | 1366957839 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICK KENT BRUEGGEMAN Owner 321-508-7378 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: FL PO2457) |
| Enumeration Date | 2017-12-06 |
| Last Update Date | 2023-01-22 |