| NPI | 1922060623 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEE HOWARD GOLDSTEIN Owner 502-339-1200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: KY 162) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: IN 517-B) |
| Enumeration Date | 2006-04-06 |
| Last Update Date | 2008-02-25 |