NPI | 1801061932 |
---|---|
Entity Type | Organization |
Authorized Contact | JOHN S JACKO Owner 304-754-7130 |
Organization Subpart ? | No |
Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: WV 10391) |
Enumeration Date | 2008-04-29 |
Last Update Date | 2009-05-07 |