| NPI | 1710159215 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH COOKUS Board Member 804-273-1717 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: VA 0103000739) |
| Enumeration Date | 2008-03-25 |
| Last Update Date | 2008-03-28 |