| NPI | 1821270406 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH HERBERT GOODWIN Sole Member/CEO 304-905-0590 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: WV 00377) |
| Enumeration Date | 2007-12-05 |
| Last Update Date | 2016-07-28 |