| NPI | 1457749939 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRENT C RICKS CEO/Chairman Of The Board 209-380-7760 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: CA E5055) |
| Enumeration Date | 2015-01-06 |
| Last Update Date | 2015-01-06 |