| NPI | 1164897971 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALLISON MENKE Sole Member 706-999-9994 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: GA POD001138) |
| Enumeration Date | 2015-12-04 |
| Last Update Date | 2016-02-15 |