| NPI | 1871627315 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID CARL CAVALLARO CEO 405-631-2333 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213EP1101X Podiatrist Primary Podiatric Medicine (Licence: OK 140) |
| Additional Taxonomies | 213ES0103X Podiatrist Foot & Ankle Surgery (Licence: OK 140) |
| Enumeration Date | 2007-03-15 |
| Last Update Date | 2011-10-25 |