NPI | 1134568124 |
---|---|
Entity Type | Organization |
Authorized Contact | BRADLEY DAVID CASTELLANO Podiatrist Owner 770-648-5040 |
Organization Subpart ? | No |
Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: GA POD000569) |
Enumeration Date | 2013-06-23 |
Last Update Date | 2015-01-20 |