| NPI | 1184770133 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK R. LIGHT Owner 770-977-8221 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: GA 630) |
| Enumeration Date | 2007-01-25 |
| Last Update Date | 2009-05-29 |