| NPI | 1871106286 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRITTANY KAY PARKER Owner 505-716-3060 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics |
| Additional Taxonomies | 261QP1100X Clinic/Center, Podiatric |
| Enumeration Date | 2020-08-25 |
| Last Update Date | 2022-06-20 |