Organization
EASY WALK FOOT CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AZUKA IFEYINWA NWAEDOZIE D.P.M (PODIATRIST/OWNER)
(678) 489-6589
Entity
Organization
Contact information
Practice address
101 BECKETT LN, SUITE 104, FAYETTEVILLE, GA 30214-7155
(678) 489-6589
(678) 489-6522
Mailing address
3364 MEDINA DR, JONESBORO, GA 30236-6873
(646) 489-6589
(678) 489-6522
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
POD001142
GA
Other
Enumeration date
04/05/2011
Last updated
07/16/2012
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