NPI | 1720065469 |
---|---|
Entity Type | Organization |
Authorized Contact | BRIAN J MAZZEI Vice President 276-623-0333 |
Organization Subpart ? | No |
Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: VA 010300940) |
Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: VA C10300942) |
Enumeration Date | 2005-12-23 |
Last Update Date | 2009-06-29 |