| NPI | 1962812321 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES JAY BRANTLEY Managing Member 1479-582-1199 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery |
| Enumeration Date | 2014-05-06 |
| Last Update Date | 2014-05-06 |