| NPI | 1861691883 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN A NETTESHEIM Owner 314-849-9009 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: MO 000531) |
| Enumeration Date | 2007-07-11 |
| Last Update Date | 2015-05-08 |