| NPI | 1821263963 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES LOUIS BOUCHARD Medical Director 770-255-0420 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: GA POD000418) |
| Enumeration Date | 2008-04-29 |
| Last Update Date | 2012-04-30 |