| NPI | 1578182895 |
|---|---|
| Doing Business As | MID LAKE FOOT AND ANKLE |
| Entity Type | Organization |
| Authorized Contact | BREANNA J. FERGUSON Owner 352-432-8434 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery |
| Enumeration Date | 2020-04-16 |
| Last Update Date | 2020-04-16 |