| NPI | 1740509025 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUDY NONGLAK OUTSA President 502-409-5580 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: KY 00291) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2010-05-25 |
| Last Update Date | 2024-01-23 |