| NPI | 1639344781 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN A KING Podiatrist 708-848-0021 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2008-04-29 |
| Last Update Date | 2008-05-07 |