Healthcare Provider Details

I. General information

NPI: 1639234032
Provider Name (Legal Business Name): A. & F. FOOT CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/26/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 SEVERANCE CIR SUITE #501
CLEVELAND HEIGHTS OH
44118-1566
US

IV. Provider business mailing address

5 SEVERANCE CIR SUITE #501
CLEVELAND HEIGHTS OH
44118-1566
US

V. Phone/Fax

Practice location:
  • Phone: 216-381-8122
  • Fax: 216-381-8123
Mailing address:
  • Phone: 216-381-8122
  • Fax: 216-381-8123

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number36.001997
License Number StateOH

VIII. Authorized Official

Name: DR. FRANKLIN HOWARD KODISH
Title or Position: PRESIDENT
Credential: D.P.M.
Phone: 216-381-8122