| NPI | 1619412681 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARMELITA R REYES Managing Member 330-759-8690 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: OH 36003113R) |
| Enumeration Date | 2016-12-30 |
| Last Update Date | 2016-12-30 |