Healthcare Provider Details

I. General information

NPI: 1255805446
Provider Name (Legal Business Name): NEWEY FOOT CLINIC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/22/2019
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

155 5TH ST NE
BARBERTON OH
44203-3332
US

IV. Provider business mailing address

4014 MEDINA RD # 1021
AKRON OH
44333-4568
US

V. Phone/Fax

Practice location:
  • Phone: 330-615-3906
  • Fax: 330-615-3908
Mailing address:
  • Phone: 234-334-1111
  • Fax: 949-868-4405

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213EP1101X
TaxonomyPrimary Podiatric Medicine Podiatrist
License Number
License Number StateNULL

VIII. Authorized Official

Name: JENNY WISE
Title or Position: PRACTICE ADMINISTRATOR
Credential:
Phone: 234-334-1111