| NPI | 1841490414 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID J LOISELLE Owner 727-596-9703 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist Foot & Ankle Surgery (Licence: FL 1880) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: FL 1880) |
| Enumeration Date | 2007-07-23 |
| Last Update Date | 2010-07-20 |