| NPI | 1700145372 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MACHELLE GORDON Credentialing Specialist 330-723-2111 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: OH 36003592) |
| Enumeration Date | 2012-05-16 |
| Last Update Date | 2012-05-16 |