| NPI | 1467652321 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TANISHA RENNEE RICHMOND Podiatrist 937-219-9831 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP1100X Clinic/Center, Podiatric (Licence: OH 59.000143) |
| Enumeration Date | 2007-07-19 |
| Last Update Date | 2007-07-19 |