| NPI | 1386984573 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHAD SIMMONS Owner 239-278-1155 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist Foot & Ankle Surgery (Licence: CO POD0000702) |
| Enumeration Date | 2013-02-25 |
| Last Update Date | 2013-02-25 |