| NPI | 1497192678 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANTA L GRIFFIN Podiatrist 901-500-5103 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213EP1101X Podiatrist, Primary Podiatric Medicine (Licence: TN 711) |
| Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: TN 711) |
| 213ES0131X Podiatrist, Foot Surgery (Licence: TN 711) | |
| Enumeration Date | 2013-05-29 |
| Last Update Date | 2014-06-20 |