Healthcare Provider Details

I. General information

NPI: 1548358732
Provider Name (Legal Business Name): ELEVATE FOOT & ANKLE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/11/2006
Last Update Date: 09/02/2025
Certification Date: 04/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2880 PLYMOUTH AVE
ROCKY RIVER OH
44116-3209
US

IV. Provider business mailing address

2880 PLYMOUTH AVE
ROCKY RIVER OH
44116-3209
US

V. Phone/Fax

Practice location:
  • Phone: 440-333-5888
  • Fax: 440-333-6766
Mailing address:
  • Phone: 440-333-5888
  • Fax: 440-333-6766

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number826250
License Number StateOH

VIII. Authorized Official

Name: DR. DAVID A KRETCH
Title or Position: PRESIDENT
Credential: DPM
Phone: 440-465-8810