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Organization
FOOT AND ANKLE WELLNESS CENTER
Active
Organization
FOOT AND ANKLE WELLNESS CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEITH MILLER (OWNER)
(678) 513-8777
Entity
Organization
Contact information
Practice address
416 PIRKLE FERRY RD STE J500, CUMMING, GA 30040-9221
(678) 513-8777
(678) 513-8999
Mailing address
416 PIRKLE FERRY RD STE J500, CUMMING, GA 30040-9221
(678) 513-8777
(678) 513-8999
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
GA000916
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10059160
—
GA
05
—
N327176
—
GA
01
—
P00290978
MEDICARE RAILROAD
GA
Enumeration date
09/12/2007
Last updated
09/12/2007
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