| 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 |