| NPI | 1932281797 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANNON PACE Billing Manager 706-653-5501 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: GA 000895) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: GA 009080) |
| 213E00000X Podiatrist (Licence: GA 000814) | |
| 213E00000X Podiatrist (Licence: AL 236) | |
| Enumeration Date | 2006-10-20 |
| Last Update Date | 2012-11-02 |