| NPI | 1881869535 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN P MIKETA Owner 919-557-5148 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP1100X Clinic/Center Podiatric |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2008-04-24 |
| Last Update Date | 2008-08-05 |