Organization Name: | CAROLINA FOOT HEALTH CENTER, PA |
NPI Number: | 1164696100 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | ROY WALTER SPRINKLE (PODITORY) |
Mailing Address: | 1103 Glenns Bay Rd Surfside Beach |
State: | SC US |
Postal Code: | 295754722 |
Phone Number: | 8432388989 |
Fax Number: | |
NPI Enumeration Date: | 04/22/2008 |
NPI Last Update Date: | 04/22/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 213ES0131X |
License Number: | 99-0141 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
Taxonomy Classification: | Podiatrist |
Taxonomy Specialization: | Foot Surgery |
Taxonomy Definition: |