| NPI | 1780856039 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SONYA FAIRCLOTH Secretary 804-330-2467 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: VA 0103000905) |
| Enumeration Date | 2008-03-27 |
| Last Update Date | 2008-03-28 |