| NPI | 1457732133 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TANISHA SMITH Podiatrist 317-397-1718 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213EP1101X Podiatrist, Primary Podiatric Medicine (Licence: IN 07001108A) |
| Enumeration Date | 2015-06-17 |
| Last Update Date | 2015-07-20 |