| NPI | 1386956704 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KURT W DAVIS Manager 360-694-3668 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: WA PO00000682) |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment (Licence: WA PO000000682) |
| Enumeration Date | 2010-07-14 |
| Last Update Date | 2010-09-14 |