| NPI | 1831108869 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY B PUPP Owner 910-343-8889 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: NC 449) |
| Additional Taxonomies | 213ES0131X (Licence: NC 230) |
| Enumeration Date | 2006-08-07 |
| Last Update Date | 2007-11-05 |