Organization
DIVINE PODIATRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALIYA MATTHEWS DPM (PODIATRIST)
(609) 922-1866
Entity
Organization
Contact information
Practice address
1204 BENTLEY ESTATES DR, DACULA, GA 30019-7786
(609) 922-1866
Mailing address
1204 BENTLEY ESTATES DR, DACULA, GA 30019-7786
(609) 922-1866
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
POD00148
GA
Other
Enumeration date
08/08/2014
Last updated
04/18/2020
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