| NPI | 1790900249 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ETHEL B DANDY Pedorthic Owner 803-625-4100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 211D00000X Assistant, Podiatric |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| 335E00000X Prosthetic/Orthotic Supplier | |
| Enumeration Date | 2007-04-17 |
| Last Update Date | 2008-07-24 |