| NPI | 1598097149 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAVAN S BASS CEO 334-538-1020 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: GA POD001101) |
| Enumeration Date | 2010-02-08 |
| Last Update Date | 2011-04-26 |