| NPI | 1720590078 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JARED C SHIPPEE Owner And President 435-200-5756 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0000X Podiatrist, Sports Medicine (Licence: SD 231) |
| Enumeration Date | 2017-10-26 |
| Last Update Date | 2017-10-26 |