| NPI | 1073070579 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRET J HINTZE Authorized Official 770-999-0804 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery |
| Additional Taxonomies | 213E00000X Podiatrist |
| 213ES0131X | |
| Enumeration Date | 2019-02-21 |
| Last Update Date | 2019-02-21 |