| NPI | 1831648161 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RENEE L MACKEY Authorized Official 330-673-3505 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: OH 36003579) |
| Enumeration Date | 2016-09-28 |
| Last Update Date | 2016-09-28 |