| NPI | 1588365001 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIC STORTS Owner 740-821-6377 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP1100X Clinic/Center, Podiatric |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| Enumeration Date | 2023-03-13 |
| Last Update Date | 2026-01-27 |