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Contact Information

LOWER EXTREMITY DIAGNOSTICS, LLC
6911 TARA BOULEVARD
JONESBORO, GA30236
 Phone: 770-477-9535
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Radiology

213ER0200X 48 Podiatry
Indicates primary specialty

NPI Profile & details for LOWER EXTREMITY DIAGNOSTICS LLC · (Female)

NPI # 1770991861
Status Active
Credentials
Entity Individual
Enumeration date 08/01/2014
Last updated 08/01/2014 - About 12 years ago
Sole proprietor 1 Not specified
Identifiers
  • GA License # POD000382
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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