Organization
THAT FOOT DOCTOR, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHELLE MCCARROLL DPM (PHYSICIAN)
(610) 841-3535
Entity
Organization
Contact information
Practice address
1251 S CEDAR CREST BLVD, STE 301, ALLENTOWN, PA 18103-6205
(610) 841-3535
Mailing address
1251 S CEDAR CREST BLVD, STE 301, ALLENTOWN, PA 18103-6205
(610) 841-3535
Taxonomy
Speciality
Code
Description
License number
State
261QP1100X
Podiatric Clinic/Center
Primary
SC003851-L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
15259880401
—
PA
Enumeration date
05/30/2013
Last updated
02/16/2015
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