| NPI | 1962629824 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY ALLEN VAN DYNE President 559-435-0261 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP1100X Clinic/Center, Podiatric (Licence: CA E2025) |
| Enumeration Date | 2007-04-19 |
| Last Update Date | 2012-02-24 |