Organization
LOWER EXTREMITY DIAGNOSTICS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STANLEY KALISH (MEMBER)
(770) 477-9535
Entity
Organization
Contact information
Practice address
6911 TARA BOULEVARD, JONESBORO, GA 30236
(770) 477-9535
Mailing address
6911 TARA BOULEVARD, JONESBORO, GA 30236
(770) 477-9535
(770) 471-7826
Taxonomy
Speciality
Code
Description
License number
State
213ER0200X
Radiology Podiatrist
Primary
POD000382
GA
Other
Enumeration date
08/01/2014
Last updated
08/01/2014
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