MEDICARE: SCHUSSLER CONCIERGE PODIATRY LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213E00000X	Podiatrist

General Provider Information

NPI Number	:	1740927821
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SCHUSSLER CONCIERGE PODIATRY LLC

Provider Business Mailing Address
First Line	:	2008 ZUNI DR
Second Line	:
City	:	LAKE WAYNOKA
State	:	OH
Zip	:	45171-9272
Country	:	US
Telephone Number	:	937-392-0200
Fax Number	:

Provider Business Practice Location Address
First Line	:	2008 ZUNI DR
Second Line	:
City	:	LAKE WAYNOKA
State	:	OH
Zip	:	45171-9272
Country	:	US
Telephone Number	:	937-392-0200
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	JEFFREY SCHUSSLER
Credential	:	DPM
Telephone Number	:	937-392-0200

Provider Enumeration Date	:	05/19/2022
Last Update Date	:	05/19/2022

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