Organization
TRIDENT USA FOOT CARE SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIMOTHY BOES (COO)
(252) 985-1371
Entity
Organization
Contact information
Practice address
800 TIFFANY BLVD STE 101, ROCKY MOUNT, NC 27804-1807
(252) 985-1371
Mailing address
800 TIFFANY BLVD STE 101, ROCKY MOUNT, NC 27804-1807
(252) 985-1371
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
—
—
Other
Enumeration date
10/19/2015
Last updated
12/07/2015
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