Individual
GRANT AUSTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CPED
Contact information
Practice address
5035 FLORENCE ST, OAKWOOD, GA 30566-2646
(770) 539-9474
(770) 531-1670
Mailing address
14 BROOKS DR, ORMOND BEACH, FL 32176-3722
(386) 236-9672
(386) 236-9672
Taxonomy
Speciality
Code
Description
License number
State
224L00000X
Pedorthist
Primary
CPED2311
GA
Other
Enumeration date
09/29/2017
Last updated
09/29/2017
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