| NPI | 1386804045 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FONCO HOWARD President 770-315-2280 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213EP1101X Podiatrist, Primary Podiatric Medicine (Licence: GA POD000769) |
| Enumeration Date | 2008-06-16 |
| Last Update Date | 2008-06-16 |