| NPI | 1780605055 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY LYNN ADSIT Owner 765-664-0107 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: IN 07000307) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2006-07-22 |
| Last Update Date | 2015-06-18 |