| NPI | 1629571963 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAEL BEACHLER Owner 307-754-9191 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2018-03-13 |
| Last Update Date | 2018-03-13 |