| NPI | 1720281496 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN PETER DESCHAMPS Owner 860-875-7078 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0131X Podiatrist, Foot Surgery (Licence: CT 000504) |
| Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: CT 000504) |
| 213E00000X Podiatrist (Licence: CT 000504) | |
| Enumeration Date | 2007-06-08 |
| Last Update Date | 2012-08-23 |