Individual
GRACE IVIE EJAIFE-AUSTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPM
Contact information
Practice address
1043 N HOUSTON RD, WARNER ROBINS, GA 31093-1505
(478) 328-6466
(478) 328-1338
Mailing address
1043 N HOUSTON RD, WARNER ROBINS, GA 31093-1505
(478) 328-6466
(478) 328-1338
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
POD001084
GA
Other
Enumeration date
08/24/2007
Last updated
09/11/2007
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