NPI | 1497873129 |
---|---|
Entity Type | Organization |
Authorized Contact | BRUCE ALTON OLSON Podiatrist 805-486-8710 |
Organization Subpart ? | No |
Primary Taxonomy | 213E00000X Podiatrist |
Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: CA E1206) |
Enumeration Date | 2007-03-27 |
Last Update Date | 2022-07-21 |