| NPI | 1861767584 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRAD W. RUETENIK President 760-753-1804 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP1100X Clinic/Center, Podiatric (Licence: CA E3866) |
| Enumeration Date | 2012-03-13 |
| Last Update Date | 2012-03-13 |