Healthcare Provider Details

I. General information

NPI: 1497060164
Provider Name (Legal Business Name): FAMILY FOOT & ANKLE CENTER INC PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2010
Last Update Date: 04/10/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8474 WINTON RD
CINCINNATI OH
45231-4939
US

IV. Provider business mailing address

8474 WINTON RD
CINCINNATI OH
45231-4939
US

V. Phone/Fax

Practice location:
  • Phone: 513-728-4800
  • Fax: 513-728-4601
Mailing address:
  • Phone: 513-728-4800
  • Fax: 513-728-4601

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number36003377
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number36003377
License Number StateOH

VIII. Authorized Official

Name: CYNTHIA D MILLER
Title or Position: PRESIDENT
Credential: DPM
Phone: 513-728-4800