| NPI | 1689859894 |
|---|---|
| Doing Business As | PODIATRY PROFESSIONAL SERVICES |
| Entity Type | Organization |
| Authorized Contact | ALFONSO F BANUELOS Chief Medical Officer 4088-855-0000 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 213E00000X Podiatrist |
| Enumeration Date | 2008-01-07 |
| Last Update Date | 2008-01-07 |