| Doctor Name: | DR. LARA SUE PODUSKA |
| NPI Number: | 1356346860 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | D.P.M. |
| License Number: | 36002924P |
| Business Practice Address: | 24816 Aurora Rd Suite A Bedford Heights, OH - 441461758 |
| Business Phone Number: | 2166620027 |
| Business Fax Number: | |
| Mailing Address: | 24816 Aurora Rd, Suite A BEDFORD HEIGHTS |
| State: | OH |
| Postal Code: | 441461758 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 06/21/2005 |
| NPI Last Update Date: | 07/05/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 213EP1101X |
| License Number: | 36002924P |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OH |
| Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
| Taxonomy Classification: | Podiatrist |
| Taxonomy Specialization: | Primary Podiatric Medicine |
| Taxonomy Definition: | |