Organization
ADVANCED DIABETIC SOLUTIONS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GREGORY PETER SANTULLI (PRESIDENT)
(770) 339-1190
Entity
Organization
Contact information
Practice address
1580 ATKINSON RD, LAWRENCEVILLE, GA 30043-5600
(770) 339-1190
(770) 339-1192
Mailing address
1580 ATKINSON RD, LAWRENCEVILLE, GA 30043-5600
(770) 339-1190
(770) 339-1192
Taxonomy
Speciality
Code
Description
License number
State
222Z00000X
Orthotist
13
GA
224900000X
Mastectomy Fitter
CFM01708
DE
224L00000X
Pedorthist
CPED1966
DE
224L00000X
Pedorthist
CPED2905
DE
225000000X
Orthotic Fitter
C49737
MD
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
09/22/2006
Last updated
09/30/2015
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