| NPI | 1922296250 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SPENCER CARLTON MISNER Provider Medical Director 706-226-1130 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP1100X Clinic/Center, Podiatric |
| Enumeration Date | 2007-10-11 |
| Last Update Date | 2008-07-10 |