| NPI | 1376921072 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KYLE V TEMPLIN President 262-215-3959 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist Foot & Ankle Surgery (Licence: IL 016005571) |
| Enumeration Date | 2015-05-13 |
| Last Update Date | 2015-05-13 |