Healthcare Provider Details
I. General information
NPI: 1932156270
Provider Name (Legal Business Name): SOUTHWEST FOOT AND ANKLE ASSOCIATES, INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/30/2006
Last Update Date: 09/23/2014
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7255 OLD OAK BLVD SUITE C308
CLEVELAND OH
44130-3329
US
IV. Provider business mailing address
7255 OLD OAK BLVD SUITE C308
CLEVELAND OH
44130-3329
US
V. Phone/Fax
- Phone: 440-816-2735
- Fax: 440-816-5306
- Phone: 440-816-2735
- Fax: 440-816-5306
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 213E00000X |
| Taxonomy | Podiatrist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JAMES
R
HOLFINGER
Title or Position: PRESIDENT
Credential: DPM
Phone: 440-816-2735