| NPI | 1104990415 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT HARRISON LISENBY President 334-671-1441 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: AL 144) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: GA 511) |
| Enumeration Date | 2006-11-20 |
| Last Update Date | 2009-05-26 |