Organization Name: | PERSONAL FOOT AND ANKLE SPECIALIST |
NPI Number: | 1457308132 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | THUY GIANG (PRESIDENT) |
Mailing Address: | 1240 Ga Highway 15 N Sandersville |
State: | GA US |
Postal Code: | 310827303 |
Phone Number: | 4785521086 |
Fax Number: | 4785526333 |
NPI Enumeration Date: | 05/28/2006 |
NPI Last Update Date: | 12/31/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 213EP1101X |
License Number: | POD000790 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
Taxonomy Classification: | Podiatrist |
Taxonomy Specialization: | Primary Podiatric Medicine |
Taxonomy Definition: |