| NPI | 1750400768 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY EDWARD SHOOK Practice Manager 304-755-8088 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: WV 00315) |
| Enumeration Date | 2007-03-29 |
| Last Update Date | 2007-10-25 |