| NPI | 1376749168 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHERESE R DILLON CEO 219-791-0667 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213EP1101X Podiatrist, Primary Podiatric Medicine (Licence: IN 07000980A) |
| Enumeration Date | 2007-06-27 |
| Last Update Date | 2020-08-22 |