| NPI | 1508034331 |
|---|---|
| Doing Business As | SOUTHAVEN FOOT CLINIC |
| Entity Type | Organization |
| Authorized Contact | BRIAN I SHWER Owner 662-349-7333 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213E00000X Podiatrist |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: TN DPM458) |
| Enumeration Date | 2008-02-14 |
| Last Update Date | 2021-02-01 |