| NPI | 1619301751 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRENT J TIMSON Podiatrist 620-241-3313 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: KS 12-00301) |
| Additional Taxonomies | 335E00000X Prosthetic/Orthotic Supplier (Licence: KS 12-00301) |
| Enumeration Date | 2013-08-26 |
| Last Update Date | 2013-08-26 |