| NPI | 1609973858 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUSTIN BLAKE GREEN Owner 337-364-8878 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0131X Podiatrist, Foot Surgery (Licence: LA PD324R) |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2020-08-22 |