Organization
FOLSOM ANESTHESIA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KURT ZUMWALT (CEO)
(941) 360-1566
Entity
Organization
Contact information
Practice address
1010 SPRUCE ST, ESPANOLA, NM 87532-2746
(505) 753-7111
(505) 753-4438
Mailing address
PO BOX 69323, BALTIMORE, MD 21264-9323
(941) 360-1566
(941) 358-9818
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
367500000X
Certified Registered Nurse Anesthetist
—
—
Other
Enumeration date
08/21/2020
Last updated
10/19/2020
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