| NPI | 1780776567 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN T SANDERS Owner 502-459-8127 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP1100X Clinic/Center, Podiatric |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2006-09-29 |
| Last Update Date | 2020-10-15 |