SOUTHEAST PODIATRY NPI 1154568582

NPI Information

SOUTHEAST PODIATRY is a clinic center in Marietta, GA. The provider is a facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). SOUTHEAST PODIATRY NPI is 1154568582. The provider is registered as an organization entity type.

The provider's business location address is:

3225 SHALLOWFORD RD
SUITE 200
MARIETTA, GA
ZIP 30062-266
Phone: (770) 675-7904
Fax: (770) 675-7906

The provider's authorized official is Suzanne Marie Clous .
The authorized official title is Podiatrist and has the following contact phone number (770) 852-7035.

The enumeration date for this NPI number is 1/7/2009 and was last updated on 11/19/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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