| NPI | 1609469899 |
|---|---|
| Doing Business As | PODIATRY - PINE STREET |
| Entity Type | Organization |
| Authorized Contact | BRYAN N BATSON Executive Director 601-264-6000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213E00000X Podiatrist |
| Enumeration Date | 2021-02-18 |
| Last Update Date | 2021-03-02 |