| NPI | 1760485528 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICKY DUANE WILKERSON Physician/Owner 712-262-7511 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery |
| Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery |
| Enumeration Date | 2005-05-24 |
| Last Update Date | 2016-02-16 |