| NPI | 1104218544 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY VARNER Practice Manager 912-355-6503 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: GA 885) |
| Enumeration Date | 2015-02-23 |
| Last Update Date | 2015-02-23 |