| NPI | 1952727992 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY DAVIS Credentialing Specialists 912-777-6519 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist Foot & Ankle Surgery (Licence: SC 625) |
| Enumeration Date | 2014-03-14 |
| Last Update Date | 2014-03-14 |