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NPI Code Detail

MEDICARE: FAWG SOLEHEALERS LLC

MEDICARE: FAWG SOLEHEALERS LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1213E00000XPodiatrist

General Provider Information

NPI Number : 1235792847
Entity Type Code : Organization
Provider Name (Legal Business Name) : FAWG SOLEHEALERS LLC
Provider Business Mailing Address
First Line : 2000 HAMILTON RD
Second Line :
City : COLUMBUS
State : GA
Zip : 31904-8927
Country : US
Telephone Number : 706-327-8819
Fax Number : 706-327-3147
Provider Business Practice Location Address
First Line : 2000 HAMILTON RD
Second Line :
City : COLUMBUS
State : GA
Zip : 31904-8927
Country : US
Telephone Number : 706-327-8819
Fax Number : 706-327-3147
Authorized Official
Title or Position : OWNER/PARTNERSHIP
Name : MICHAEL A SCHRECK
Credential : DPM
Telephone Number : 706-327-8819
Provider Enumeration Date : 04/18/2019
Last Update Date : 04/18/2019

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Directions to “FAWG SOLEHEALERS LLC ” Practice Location

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