| NPI | 1932421385 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN KSOR Podiatrist 864-494-0534 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213EP1101X Podiatrist, Primary Podiatric Medicine (Licence: SC 563) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: SC DE3794) |
| 332B00000X Durable Medical Equipment & Medical Supplies (Licence: SC 6460510001) | |
| Enumeration Date | 2010-02-25 |
| Last Update Date | 2018-08-17 |