| NPI | 1700425816 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN A MCKIM CEO 502-261-0050 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213E00000X Podiatrist |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2020-01-06 |
| Last Update Date | 2020-10-06 |