| NPI | 1720260409 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEAN P KOSTAKOS Owner 770-346-7500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: GA 00605) |
| Enumeration Date | 2007-12-04 |
| Last Update Date | 2007-12-21 |