NPI | 1669897690 |
---|---|
Entity Type | Organization |
Authorized Contact | BRANDON PERCIVAL President 803-285-1411 |
Organization Subpart ? | No |
Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: SC 564) |
Enumeration Date | 2014-02-27 |
Last Update Date | 2014-05-08 |