| NPI | 1760527154 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARMELITA RONQUILLO REYES Managing Member 330-746-7660 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: OH 36003113R) |
| Enumeration Date | 2007-02-21 |
| Last Update Date | 2009-04-03 |