| NPI | 1881872273 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHAD LIETTE Office Manager 937-875-2526 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP1100X Clinic/Center Podiatric (Licence: OH 36003402) |
| Enumeration Date | 2008-02-07 |
| Last Update Date | 2014-12-04 |