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Organization
AFFILIATED FOOT CARE CENTER, LLC
Active
Organization
AFFILIATED FOOT CARE CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GORDON E FOSDICK DPM (OWNER/PHYSICIAN)
(860) 349-8500
Entity
Organization
Contact information
Practice address
470 MAIN ST, MIDDLEFIELD, CT 06455-1210
(860) 349-8500
(860) 349-3081
Mailing address
470 MAIN ST, MIDDLEFIELD, CT 06455-1210
(860) 349-8500
(860) 349-3081
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
000723
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004206951
—
CT
Enumeration date
11/14/2006
Last updated
01/27/2020
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