Organization
TLC PODIATRY, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EMILY ARLENE VIA-BOWERS D.P.M. (PRESIDENT)
(912) 285-0069
Entity
Organization
Contact information
Practice address
605 MARY ST, WAYCROSS, GA 31501-3726
(912) 285-0069
Mailing address
605 MARY ST, WAYCROSS, GA 31501-3726
(912) 285-0069
Taxonomy
Speciality
Code
Description
License number
State
213EP1101X
Primary Podiatric Medicine Podiatrist
Primary
000743
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00623334B
—
GA
Enumeration date
10/06/2006
Last updated
12/03/2010
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