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Individual

NRUP TOLAT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
100 STONEFOREST DR STE 120, WOODSTOCK, GA 30189
(404) 245-4969
Mailing address
2170 SUGAR MAPLE CV NW, ACWORTH, GA 30101-8815

Taxonomy

Speciality
Code
Description
License number
State
213EP1101X
Primary Podiatric Medicine Podiatrist
POD001368
GA
213ES0000X
Sports Medicine Podiatrist
POD001368
GA
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
POD001368
GA

Other

Enumeration date
06/10/2015
Last updated
09/23/2020
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