| NPI | 1568655488 |
|---|---|
| Former Legal Business Name | MUSKOGEE FOOT CLINIC INC. |
| Entity Type | Organization |
| Authorized Contact | DAVID LACY GREEN Podiatrist 918-687-5171 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist Foot & Ankle Surgery |
| Enumeration Date | 2007-08-23 |
| Last Update Date | 2010-06-18 |