| NPI | 1588716096 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMMY E. CARLSON-LITTLE Owner 814-643-1720 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213E00000X Podiatrist |
| Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery |
| Enumeration Date | 2007-01-17 |
| Last Update Date | 2010-03-15 |