Organization
DIVINE PODIATRY CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALIYA MATTHEWS DPM (OWNER)
(609) 922-1866
Entity
Organization
Contact information
Practice address
1204 BENTLEY ESTATES DR, DACULA, GA 30019-7786
(609) 922-8166
Mailing address
1204 BENTLEY ESTATES DR, DACULA, GA 30019-7786
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
—
—
Other
Enumeration date
12/19/2018
Last updated
04/18/2020
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