| NPI | 1306183280 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROGER P THEODORE Podiatrist 478-741-1192 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0131X Podiatrist, Foot Surgery (Licence: GA POD000753) |
| Enumeration Date | 2013-01-11 |
| Last Update Date | 2013-02-04 |