| Organization Name: | CONNEAUT VALLEY HEALTH CENTER PODIATRY |
| NPI Number: | 1356473094 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MICHAEL C DOWNING (CEO) |
| Mailing Address: | 906 Washington St Conneautville |
| State: | PA US |
| Postal Code: | 164067138 |
| Phone Number: | 8143732276 |
| Fax Number: | 8145872918 |
| NPI Enumeration Date: | 03/09/2007 |
| NPI Last Update Date: | 04/14/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 213EP1101X |
| License Number: | SC004174R |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
| Taxonomy Classification: | Podiatrist |
| Taxonomy Specialization: | Primary Podiatric Medicine |
| Taxonomy Definition: | |