| NPI | 1093108763 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA DYKES Admin 404-351-0055 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery |
| Additional Taxonomies | 152W00000X Optometrist |
| Enumeration Date | 2015-03-05 |
| Last Update Date | 2025-03-25 |