| NPI | 1922137322 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENNIS TIMKO President 636-486-0033 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: MO 2001014083) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2007-03-04 |
| Last Update Date | 2024-07-31 |