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General NPI Number Information
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NPI Number | 1013354935
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Entity Type | Organization
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Legal Business Name | FIRST CHOICE PODIATRY ASSOCIATES
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Dates
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Enumeration Date | 06/01/2013
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Last Update Date | 10/03/2013
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Provider Practice Location Address
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Address Line | 836 E 65TH ST UNIT 34
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City | SAVANNAH
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State | GA
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Zip | 31405-4434
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Country | US
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Telephone | 912-777-6519
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Fax | 912-777-6584
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Provider Business Mailing Address
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Address Line | 836 E 65TH ST UNIT 34
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City | SAVANNAH
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State | GA
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Zip | 31405-4434
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Country | US
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Telephone | 912-777-6519
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Fax | 912-777-6584
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Authorized Official
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Title or Position | PODIATRIST
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Name | HEATHER DRIESSEN
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Credential | DPM
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Telephone | 912-657-0951
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0131X
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Taxonomy Name | Foot Surgery Podiatrist
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License Number | POD001173
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License Number State | GA
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