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Organization

COBB FOOT & LEG SURGICAL CENTER, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. GLYN E LEWIS DPM (PRESIDENT)
(770) 422-9856
Entity
Organization

Contact information

Practice address
165 VANN ST NE, MARIETTA, GA 30060-7249
(770) 422-9856
(770) 984-0303
Mailing address
165 VANN ST NE, MARIETTA, GA 30060-7249
(770) 422-9856
(770) 984-0303

Taxonomy

Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
GA

Other

Enumeration date
12/05/2005
Last updated
01/05/2012
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