| NPI | 1851593347 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRENA CORLENE REED Physician 419-425-3338 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: OH OH2833) |
| Additional Taxonomies | 213EP1101X Podiatrist, Primary Podiatric Medicine (Licence: OH OH 2833) |
| 213ES0000X Podiatrist, Sports Medicine (Licence: OH OH 2833) | |
| 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: OH OH 2833) | |
| Enumeration Date | 2007-06-05 |
| Last Update Date | 2012-06-27 |