| NPI | 1861549503 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIE BIRKELO Credentialing 210-756-5240 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine |
| Additional Taxonomies | 207QS0010X Family Medicine, Sports Medicine |
| 208100000X Physical Medicine & Rehabilitation | |
| 213E00000X Podiatrist | |
| 213ES0103X Podiatrist, Foot & Ankle Surgery | |
| 225100000X Physical Therapist | |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| Enumeration Date | 2007-01-04 |
| Last Update Date | 2024-01-23 |