| NPI | 1972834760 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD W JOHNSON Owner 904-826-1900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: FL P02829) |
| Enumeration Date | 2010-01-19 |
| Last Update Date | 2020-12-27 |