| NPI | 1679101760 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTINA TEIMOURI Owner 878-313-3338 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 208600000X Surgery |
| 213ES0103X Podiatrist, Foot & Ankle Surgery | |
| Enumeration Date | 2020-04-01 |
| Last Update Date | 2020-04-01 |