| NPI | 1588765440 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAWRENCE RANDOLPH GASTON Owner 785-843-0973 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: KS 1200197) |
| Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: KS 1200197) |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2012-03-14 |