| NPI | 1407925738 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENT L PETERSON Owner 928-776-0770 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist Foot & Ankle Surgery (Licence: AZ 0261AZ) |
| Enumeration Date | 2006-11-08 |
| Last Update Date | 2008-02-08 |