| NPI | 1053583666 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LATISHA CHEREE MCLEAN Office Manger 770-702-8723 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: GA POD001071) |
| Enumeration Date | 2008-03-24 |
| Last Update Date | 2021-01-19 |