| NPI | 1588248843 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIA LISSETTE PACHECO Member 423-541-7000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213E00000X Podiatrist |
| Additional Taxonomies | 213ES0103X Podiatrist Foot & Ankle Surgery |
| Enumeration Date | 2021-05-11 |
| Last Update Date | 2021-07-24 |