NPI | 1659797140 |
---|---|
Entity Type | Organization |
Authorized Contact | BRANDON PERCIVAL President 803-285-1411 |
Organization Subpart ? | No |
Primary Taxonomy | 213E00000X Podiatrist |
Additional Taxonomies | 213ES0103X Podiatrist Foot & Ankle Surgery |
213ES0131X Podiatrist Foot Surgery | |
Enumeration Date | 2014-03-09 |
Last Update Date | 2014-03-09 |