| NPI | 1467881383 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LILLIAN LORETZ Owner 912-777-3164 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213EP1101X Podiatrist, Primary Podiatric Medicine (Licence: GA 000860) |
| Enumeration Date | 2013-11-01 |
| Last Update Date | 2014-04-09 |