Provider Demographics
NPI:1235792847
Name:FAWG SOLEHEALERS LLC
Entity Type:Organization
Organization Name:FAWG SOLEHEALERS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PARTNERSHIP
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:SCHRECK
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:706-327-8819
Mailing Address - Street 1:2000 HAMILTON RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31904-8927
Mailing Address - Country:US
Mailing Address - Phone:706-327-8819
Mailing Address - Fax:706-327-3147
Practice Address - Street 1:2000 HAMILTON RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31904-8927
Practice Address - Country:US
Practice Address - Phone:706-327-8819
Practice Address - Fax:706-327-3147
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-18
Last Update Date:2019-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty