Healthcare Provider Details

I. General information

NPI: 1740479344
Provider Name (Legal Business Name): CUYAHOGA FALLS FOOT CARE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/18/2007
Last Update Date: 07/13/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

355 PORTAGE TRL STE 1
CUYAHOGA FALLS OH
44221-3254
US

IV. Provider business mailing address

355 PORTAGE TRL STE 1
CUYAHOGA FALLS OH
44221-3254
US

V. Phone/Fax

Practice location:
  • Phone: 330-923-9909
  • Fax: 330-923-4906
Mailing address:
  • Phone: 330-923-9909
  • Fax: 330-923-4906

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number36.002845
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number36.002557
License Number StateOH

VIII. Authorized Official

Name: DR. MARK W WEISSFELD
Title or Position: OWNER/ PRES.
Credential: DPM
Phone: 330-923-9909