| NPI | 1508988015 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EARLIE OWENS HAIRSTON Owner 352-683-6618 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: FL K7562) |
| Enumeration Date | 2007-04-04 |
| Last Update Date | 2025-01-30 |