| NPI | 1467639161 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAM JANNEY Billing Manager 443-522-9749 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: MD 00895) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: MD 00895) |
| Enumeration Date | 2008-01-24 |
| Last Update Date | 2008-10-13 |