| NPI | 1548545338 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DARLISS GASKINS Credentialing Manager 740-629-8277 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: UT 5876265-0501) |
| Enumeration Date | 2011-10-12 |
| Last Update Date | 2011-11-15 |