| NPI | 1467638817 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELIZABETH RUDY Admin 850-353-2396 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist Foot & Ankle Surgery (Licence: CT 000509) |
| Additional Taxonomies | 335E00000X Prosthetic/Orthotic Supplier (Licence: CT 000509) |
| Enumeration Date | 2008-01-16 |
| Last Update Date | 2024-10-30 |