Organization
ALLSTAR FOOT CARE CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BENEDICTO V BITUIN DPM (OWNER)
(404) 693-3914
Entity
Organization
Contact information
Practice address
285 BOULEVARD NE, SUITE 140, ATLANTA, GA 30312-4205
(404) 265-1044
(404) 265-1047
Mailing address
PO BOX 1065, CONYERS, GA 30012-1065
(404) 693-3914
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
000819
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00783956B
—
GA
Enumeration date
05/16/2008
Last updated
06/14/2011
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