Organization
FOOTHILLS FAMILY CARE, LLC
Active
Other names
Cory D. Carroll, M.D.
Organization subpart
No
Provider details
NPI number
Authorized official
CORY CARROLL M.D. (OWNER)
(970) 221-5858
Entity
Organization
Contact information
Practice address
1032 LUKE ST, STE 1, FORT COLLINS, CO 80524-4037
(970) 221-5858
(970) 484-7191
Mailing address
1032 LUKE ST, STE 1, FORT COLLINS, CO 80524-4037
(970) 221-5858
(970) 484-7191
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
30253
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01302538
—
CO
Enumeration date
08/27/2015
Last updated
08/27/2015
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