| NPI | 1619985504 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANET LEE HASTE Office Manager 859-236-5140 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213E00000X Podiatrist |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: KY 00228) |
| 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment (Licence: KY 00228) | |
| Enumeration Date | 2006-08-04 |
| Last Update Date | 2013-09-03 |