Individual
GREG LIFFERTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
1107 BROADRICK DR, DALTON, GA 30720-2592
(706) 278-5558
(706) 278-6334
Mailing address
2601 E. ROOSEVELT ST., PHOENIX, AZ 85008
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
POD001463
GA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/13/2017
Last updated
07/31/2020
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