Provider Demographics
NPI:1760503692
Name:NOLSVOLS INC.
Entity Type:Organization
Organization Name:NOLSVOLS INC.
Other - Org Name:FOOT SOLUTIONS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:RANDY RANDOLPH
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:SPARKS
Authorized Official - Suffix:
Authorized Official - Credentials:CERIFIED PEDORTHISTS
Authorized Official - Phone:770-594-8011
Mailing Address - Street 1:11255 WOODSTOCK ROAD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30075
Mailing Address - Country:US
Mailing Address - Phone:770-594-8011
Mailing Address - Fax:770-594-8012
Practice Address - Street 1:11255 WOODSTOCK ROAD
Practice Address - Street 2:SUITE 200
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30075
Practice Address - Country:US
Practice Address - Phone:770-594-8011
Practice Address - Fax:770-594-8012
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-02
Last Update Date:2010-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA105632174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA5359060001Medicare NSC