| NPI | 1750853313 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHELLY DIANE SEDBERRY Owner/President 417-622-0648 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery |
| Enumeration Date | 2018-12-20 |
| Last Update Date | 2020-04-15 |