| NPI | 1912512724 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN E MOORE President/Podiatrist 606-679-2773 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery |
| Enumeration Date | 2020-09-09 |
| Last Update Date | 2022-03-15 |