| NPI | 1497107734 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATCHARABHORN KLUMB Owner 216-882-5144 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP1100X Clinic/Center, Podiatric (Licence: TX 2216) |
| Enumeration Date | 2016-07-11 |
| Last Update Date | 2016-07-11 |