| NPI | 1215330972 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LANCE DOUGLAS BARRY President 770-386-8620 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP1100X Clinic/Center, Podiatric (Licence: GA POD000642) |
| Enumeration Date | 2014-10-08 |
| Last Update Date | 2014-10-08 |