| NPI | 1699958421 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRY LEE DICKERSON President/CEO 770-997-3668 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: GA 000890) |
| Enumeration Date | 2007-12-15 |
| Last Update Date | 2009-01-08 |