| NPI | 1750663571 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE ROTH Podiatrist 479-968-3338 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: AR 245) |
| Enumeration Date | 2011-09-19 |
| Last Update Date | 2012-01-19 |