| NPI | 1174713796 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK J. GREENBAUM President/Physician 770-279-2900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: GA POD000611) |
| Enumeration Date | 2007-07-30 |
| Last Update Date | 2020-01-31 |