| NPI | 1972957389 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERI LYNN BAKER Podiatrist Sole Member 918-857-3416 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: TX 2208) |
| Enumeration Date | 2016-04-21 |
| Last Update Date | 2016-05-31 |