Organization
RX FOOTCENTERS, INC.
Active
Organization
RX FOOTCENTERS, INC.
Active
Other names
LaViri Comfort Shoes & Pedorthics
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RICHARD LAWRENCE YOUNG C.PED. (PRESIDENT)
(770) 461-3360
Entity
Organization
Contact information
Practice address
570 N JEFF DAVIS DR, SUITE D, FAYETTEVILLE, GA 30214-1834
(770) 461-3360
(770) 461-4079
Mailing address
570 N JEFF DAVIS DR, SUITE D, FAYETTEVILLE, GA 30214-1834
(770) 461-3360
(770) 461-4079
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
52682648001
BCBSGA
GA
01
—
L1697
KAISER PERMANENTE
GA
Enumeration date
11/13/2006
Last updated
08/26/2008
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