| NPI | 1770800955 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIREESE MARY COOPER Podiatrist 267-972-9992 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213EP1101X Podiatrist, Primary Podiatric Medicine (Licence: PA SC003585R) |
| Enumeration Date | 2010-04-27 |
| Last Update Date | 2010-04-27 |