| NPI | 1548525918 |
|---|---|
| Doing Business As | SOUTHAVEN FOOT CLINIC |
| Entity Type | Organization |
| Authorized Contact | BRIAN SHWER Provider/Owner 662-349-7333 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0131X Podiatrist, Foot Surgery (Licence: MS 80146) |
| Enumeration Date | 2012-07-11 |
| Last Update Date | 2021-02-01 |