Organization · NPI-2
Foot Care Specialist , PLLC
Podiatrist, Foot & Ankle Surgery · Holly Springs, NC
NPI number1669417465
StatusActive
Last updated in NPPESMar 19, 2012
Details
- NPI
- 1669417465
- Entity type
- Organization (NPI-2)
- Legal business name
- Foot Care Specialist , PLLC
- Organization subpart
- No
- Enumeration date
- Jun 17, 2006
- Last updated
- Mar 19, 2012
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 213ES0103X | Podiatrist, Foot & Ankle Surgery | 480 | NC | Yes |
Practice location
1140 Holly SpringsSuite 107
Holly Springs, NC 27540-7584
Phone 919-557-0300 · Fax 919-567-0306
Mailing address
1140 Holly Springs RdSuite 107
Holly Springs, NC 27540-9634
Phone 919-342-7094 · Fax 919-400-4355
Authorized official
Lawanda F Baile Rayner
Member
9195570300
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