| NPI | 1578064853 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS W FANTAUZZO President 585-442-4990 |
| Organization Subpart ? | No |
| Primary Taxonomy | 224L00000X Pedorthist |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2018-02-22 |
| Last Update Date | 2018-05-23 |