NPI | 1659516292 |
---|---|
Entity Type | Organization |
Authorized Contact | CRAIG KEVIN SKALLA Provider 912-925-3668 |
Organization Subpart ? | No |
Primary Taxonomy | 261QP1100X Clinic/Center, Podiatric (Licence: GA 694) |
Enumeration Date | 2008-12-11 |
Last Update Date | 2009-05-11 |