Organization
SOUTHERN ORTHOTICS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CAROLYN W. BARBER (PRESIDENT)
(706) 216-0102
Entity
Organization
Contact information
Practice address
462 MEMORY LN, SUITE 120, DAWSONVILLE, GA 30534-4314
(706) 216-0102
(706) 216-0102
Mailing address
462 MEMORY LN, SUITE 120, DAWSONVILLE, GA 30534-4314
(706) 216-0102
(706) 216-0102
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00972881A
—
GA
01
—
82-00286
EVERCARE
GA
Enumeration date
04/27/2006
Last updated
04/08/2009
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