| NPI | 1952923708 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVEN O'BRYANT Owner 480-744-6234 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213EP1101X Podiatrist Primary Podiatric Medicine |
| Additional Taxonomies | 213ES0103X Podiatrist Foot & Ankle Surgery |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| Enumeration Date | 2020-05-15 |
| Last Update Date | 2020-12-17 |