Organization Name: | ANKLE & FOOT CLINIC, INC. |
NPI Number: | 1063599033 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | ROBERT J. WHITE (PRESIDENT) |
Mailing Address: | 4789 Leavitt Rd Suite B Lorain |
State: | OH US |
Postal Code: | 440532136 |
Phone Number: | 4402461200 |
Fax Number: | 4402462275 |
NPI Enumeration Date: | 11/01/2006 |
NPI Last Update Date: | 10/23/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 213ES0103X |
License Number: | 36003106 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OH |
Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
Taxonomy Classification: | Podiatrist |
Taxonomy Specialization: | Foot & Ankle Surgery |
Taxonomy Definition: |