| NPI | 1619185352 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN NATHAN BENNETT CFO 706-312-3668 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: GA POD000728) |
| Enumeration Date | 2007-05-18 |
| Last Update Date | 2010-10-28 |