| NPI | 1801013057 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS JAMES BOYSEN Owner 708-444-0646 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP1100X Clinic/Center Podiatric (Licence: IL 016002685) |
| Enumeration Date | 2007-04-19 |
| Last Update Date | 2008-03-03 |