| NPI | 1972532125 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MIRANDA ANNE GOODALE Managing Member 812-448-9290 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: IN 07001015A) |
| Enumeration Date | 2006-07-01 |
| Last Update Date | 2019-05-31 |