NPI | 1558652347 |
---|---|
Doing Business As | BEACON MEDICAL GROUP SPECIALISTS BREMEN |
Entity Type | Organization |
Authorized Contact | JEFFREY P. COSTELLO VP/CFO 574-647-3549 |
Organization Subpart ? | No |
Primary Taxonomy | 213E00000X Podiatrist (Licence: IN 07001058A) |
Enumeration Date | 2011-04-27 |
Last Update Date | 2016-08-30 |