| NPI | 1790960508 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANE H STEPHENS Office Manager 850-476-2805 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| Enumeration Date | 2007-12-31 |
| Last Update Date | 2012-10-11 |