| NPI | 1770615148 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICTOR LEWIS HORSLEY Owner 618-222-6866 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: IL 016.004072) |
| Enumeration Date | 2007-03-12 |
| Last Update Date | 2008-07-25 |