| NPI | 1528270402 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUSSELL LYNN MCKINLEY Owner 270-769-1303 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: KY 00280) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2007-05-04 |
| Last Update Date | 2015-02-18 |