NPI Profile for BIG HORN FOOT CLINIC PC in POWELL, WY.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Surgery, Foot & Ankle |
213ES0103X | 48 | Podiatry | |
Durable Medical Equipment & Medical Supplies |
332B00000X | 54 | Other Medical Supply Company |
| NPI Number | 1245365154 |
|
| Status | Active | |
| Credentials | ||
| Entity | Individual | |
| Enumeration date | 02/22/2007 | |
| Last updated | 09/16/2014 - About 12 years ago | |
| Sole proprietor 1 | Not specified | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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