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Organization

SEACOAST FOOT SURGERY ASSOC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ROXANNE RAESIDE WILTON CAPPM EFPM CPODCS (PRACTICE ADMINISTRATOR)
(603) 430-8505
Entity
Organization

Contact information

Practice address
330 BORTHWICK AVENUE, SUITE 112, PORTSMOUTH, NH 03801
(603) 430-8505
(603) 436-8381
Mailing address
330 BORTHWICK AVENUE, SUITE 112, PORTSMOUTH, NH 03801
(603) 430-8505
(603) 436-8381

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
0183
NH
213E00000X
Podiatrist
POD212
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
40368267
NH
Enumeration date
11/01/2006
Last updated
01/06/2011
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