| NPI | 1700060902 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON CANNON LEVITRE Podiatrist 307-789-8997 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: WY 127) |
| Enumeration Date | 2007-12-24 |
| Last Update Date | 2008-01-06 |