| NPI | 1912048711 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVEN S WREGE Owner 505-271-9900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist Foot & Ankle Surgery (Licence: NM 212) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: NM 212) |
| Enumeration Date | 2007-02-12 |
| Last Update Date | 2012-01-31 |