| NPI | 1952667305 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CORLISS LA-SHUNUETTE AUSTIN-HARRIS President 404-483-9761 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213EP1101X Podiatrist, Primary Podiatric Medicine (Licence: GA POD000689) |
| Enumeration Date | 2012-04-10 |
| Last Update Date | 2012-04-19 |