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General NPI Number Information
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NPI Number | 1124136437
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Entity Type | Organization
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Legal Business Name | CARROLL FOOTWORKS SURGERY CENTER ,LLC
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Dates
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Enumeration Date | 08/27/2006
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Last Update Date | 09/02/2009
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Provider Practice Location Address
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Address Line | 4 GLYNDON DR SUITE 2 A
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City | REISTERSTOWN
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State | MD
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Zip | 21136-2000
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Country | US
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Telephone | 410-795-2155
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Fax | 410-795-2154
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Provider Business Mailing Address
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Address Line | 4 GLYNDON DR SUITE 2 A
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City | REISTERSTOWN
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State | MD
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Zip | 21136-2000
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Country | US
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Telephone | 410-795-2155
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Fax | 410-795-2154
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. ANNETTE JOYCE
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Credential | D.P.M.
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Telephone | 410-795-2155
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number | A1428
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License Number State | MD
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