NPI age
20 years
Enumerated 2006-05-19
Across 397 active podiatrist providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 05 (GA) | 000709574E | |
| 01 (GA) | POD000775 | PODIATRY LICENSE |
| 01 (GA) | 3274611900 | PECOS |
Solo or small practice. No other active providers share this practice address in NPPES. This provider is listed as a sole proprietor.
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