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Organization
GWINNETT PODIATRY ASSOCIATES LLC
Active
Organization
GWINNETT PODIATRY ASSOCIATES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD P MISTRETTA DPM (MANAGING PARTNER)
(770) 232-9778
Entity
Organization
Contact information
Practice address
545 OLD NORCROSS RD, SUITE 300, LAWRENCEVILLE, GA 30045-3389
(770) 963-6300
(770) 682-0578
Mailing address
545 OLD NORCROSS RD, SUITE 300, LAWRENCEVILLE, GA 30045-3389
(770) 963-6300
(770) 682-0578
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
00742
GA
Other
Enumeration date
02/05/2007
Last updated
08/22/2020
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