| NPI | 1639448244 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAREY A BLEDSOE President/Chief Executive Officer 909-946-6643 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery |
| Enumeration Date | 2011-12-28 |
| Last Update Date | 2011-12-28 |