| NPI | 1023563210 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN MOORE Podiatrist 478-216-5534 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: GA POD001181) |
| Enumeration Date | 2016-08-17 |
| Last Update Date | 2016-08-17 |