| NPI | 1720355670 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TOMEKO L MCPHILLIPS Owner 334-872-5636 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: AL 248) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: AL 256) |
| Enumeration Date | 2011-11-21 |
| Last Update Date | 2011-12-09 |