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Organization

ALLEN LAZERSON

Active
Parent organization
A FAMILY PODIATRY CENTER
Other names
A Family Podiatry Center
Organization subpart
Yes

Provider details

NPI number
Legal business name
A FAMILY PODIATRY CENTER
Authorized official
DR. ALLEN LAZERSON DPM (OWNER)
(770) 951-8976
Entity
Organization

Contact information

Practice address
1234 POWERS FERRY RD, SUITE 103, MARIETTA, GA 30067-9414
(770) 951-8976
(770) 951-8988
Mailing address
1234 POWERS FERRY RD, SUITE 103, MARIETTA, GA 30067-9414
(770) 951-8976
(770) 951-8988

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
000496
GA
332B00000X
Durable Medical Equipment & Medical Supplies
POD000496
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00296458A
GA
Enumeration date
07/22/2007
Last updated
08/14/2008
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