| NPI | 1952523508 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYNN H STAFFORD President 260-436-3579 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0131X Podiatrist Foot Surgery (Licence: IN 07000636A) |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2012-10-08 |