| NPI | 1962977272 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRANDON JAMES SLADE Owner 805-235-3887 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213E00000X Podiatrist |
| Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery |
| Enumeration Date | 2018-10-12 |
| Last Update Date | 2018-12-05 |