| NPI | 1548439672 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOAN DEKLE Office Manager 229-227-1997 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0131X Podiatrist Foot Surgery (Licence: GA 000695) |
| Enumeration Date | 2008-02-22 |
| Last Update Date | 2008-02-22 |