| NPI | 1922272012 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LATANYA FYNE Physician 706-739-0020 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: GA 000619) |
| Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: GA 000619) |
| Enumeration Date | 2008-04-18 |
| Last Update Date | 2008-04-18 |