| NPI | 1952390221 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN LARRY CLEMENTS President 540-885-8891 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: VA 0103000391) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: VA 0103000371) |
| 213E00000X Podiatrist (Licence: VA 0103300877) | |
| Enumeration Date | 2005-10-19 |
| Last Update Date | 2010-11-22 |