| NPI | 1629447511 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICHOLE DANIELLE MANNING Office Manager 912-265-0709 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: GA POD000997) |
| Enumeration Date | 2015-09-21 |
| Last Update Date | 2017-01-17 |