| NPI | 1811142250 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES WALTER KELLEY Sole Proprietor 317-786-2239 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0131X Podiatrist, Foot Surgery (Licence: IN 07000355A) |
| Enumeration Date | 2008-11-26 |
| Last Update Date | 2009-02-18 |