| NPI | 1922132760 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMMY KATHRYN GEPHART Owner 734-414-0875 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0131X Podiatrist, Foot Surgery (Licence: MI 5901002100) |
| Enumeration Date | 2007-03-15 |
| Last Update Date | 2020-08-22 |