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General NPI Number Information
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NPI Number | 1487464905
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Entity Type | Organization
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Legal Business Name | FOOT SOLUTIONS EAST COBB GA LLC
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Dates
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Enumeration Date | 01/08/2025
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Last Update Date | 01/08/2025
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Provider Practice Location Address
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Address Line | 4101 ROSWELL RD STE 800
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City | MARIETTA
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State | GA
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Zip | 30062-6292
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Country | US
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Telephone | 770-984-0844
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Fax |
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Provider Business Mailing Address
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Address Line | 223 ROSWELL ST STE 202
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City | ALPHARETTA
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State | GA
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Zip | 30009-2019
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | VP OF OPERATIONS
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Name | TAYLOR BERRY
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Credential |
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Telephone | 480-747-7778
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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