| NPI | 1871524595 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NANCY A TROUTMAN Moa Insurance Processor 704-394-4980 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2008-06-30 |