| NPI | 1891137048 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVEN THOU PRAK Sole Owner 757-597-7699 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0131X Podiatrist, Foot Surgery (Licence: VA 0103301081) |
| Enumeration Date | 2013-07-29 |
| Last Update Date | 2013-12-09 |