| NPI | 1699339804 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN DUCK Chief Financial Officer 054-285-8900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213EP1101X Podiatrist Primary Podiatric Medicine |
| Enumeration Date | 2019-04-24 |
| Last Update Date | 2024-12-11 |