NPI | 1720467004 |
---|---|
Entity Type | Organization |
Authorized Contact | BRYAN FALLIS Dpm/Owner 859-341-2440 |
Organization Subpart ? | No |
Primary Taxonomy | 213E00000X Podiatrist |
Additional Taxonomies | 335E00000X Prosthetic/Orthotic Supplier |
Enumeration Date | 2015-05-20 |
Last Update Date | 2020-01-29 |