| NPI | 1396925871 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONNA BERNARD Practice Manager 618-322-4579 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: IL 016002736) |
| Enumeration Date | 2007-11-13 |
| Last Update Date | 2011-04-14 |