| NPI | 1659343754 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN STUART LANHAM Podiatrist 414-541-5566 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: WI 750) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2006-02-02 |
| Last Update Date | 2008-04-16 |