Organization
SOUTHERN PODIATRY FOOT AND ANKLE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICK THORNTON DMP (OWNER)
(312) 752-7713
Entity
Organization
Contact information
Practice address
212 LAKE PEHAMA TRAIL, HOMER, GA 30547
(312) 752-7713
Mailing address
212 LAKE PEHAMA TRAIL, HOMER, GA 30547
(312) 752-7713
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
5981134
TN
Other
Enumeration date
12/15/2008
Last updated
12/15/2008
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