Organization
MAKE YOURSELF, LLC
Active
Other names
Sole Source Podiatry
Organization subpart
No
Provider details
NPI number
Authorized official
BRADLEY R HAMMERSLEY DPM (OWNER)
(765) 244-7440
Entity
Organization
Contact information
Practice address
128 W 5TH ST, PERU, IN 46970-2139
(765) 244-7440
Mailing address
128 W 5TH ST, PERU, IN 46970-2139
(765) 244-7440
Taxonomy
Speciality
Code
Description
License number
State
213ES0131X
Foot Surgery Podiatrist
Primary
07000906A
IN
Other
Enumeration date
04/11/2018
Last updated
04/11/2018
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