Healthcare Provider Details

I. General information

NPI: 1215696315
Provider Name (Legal Business Name): PREMIER FOOT & ANKLE CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/16/2021
Last Update Date: 03/28/2024
Certification Date: 03/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5454 FULTON DR NW
CANTON OH
44718-1727
US

IV. Provider business mailing address

3593 S ARLINGTON RD STE C
AKRON OH
44312-5271
US

V. Phone/Fax

Practice location:
  • Phone: 330-899-1051
  • Fax:
Mailing address:
  • Phone: 330-899-1051
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number
License Number State

VIII. Authorized Official

Name: KIMBERLY S. KEMPER
Title or Position: PRESIDENT
Credential: DPM
Phone: 330-899-1051