| NPI | 1043827280 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LATISHA CHEREE MCLEAN Office Manager 770-702-8723 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery |
| Enumeration Date | 2020-09-30 |
| Last Update Date | 2020-09-30 |