| NPI | 1538430178 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GAY L GUSTAFSON Owner 505-299-4487 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: NM 252) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2012-01-12 |
| Last Update Date | 2023-03-30 |