Organization
FOOTPRINTS CAROLINA INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARY C BRANNON (BILLING COORDINATOR)
(704) 524-2091
Entity
Organization
Contact information
Practice address
138 ALLENDALE DR, FOREST CITY, NC 28043-2874
(828) 248-9990
(828) 248-9770
Mailing address
2020 REMOUNT RD, GASTONIA, NC 28054-7476
(704) 884-2500
(704) 524-2097
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
36265
—
NC
Enumeration date
05/09/2008
Last updated
05/09/2008
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