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General NPI Number Information
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NPI Number | 1033298385
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Entity Type | Organization
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Legal Business Name | NORTHCOAST FOOT AND ANKLE ASSOCIATES, INC.
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Dates
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Enumeration Date | 11/06/2006
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Last Update Date | 06/13/2013
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Provider Practice Location Address
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Address Line | 23823 LORAIN RD SUITE 280
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City | NORTH OLMSTED
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State | OH
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Zip | 44070-2254
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Country | US
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Telephone | 440-734-5662
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Fax | 440-734-0989
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Provider Business Mailing Address
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Address Line | 23823 LORAIN RD SUITE 280
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City | NORTH OLMSTED
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State | OH
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Zip | 44070-2254
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Country | US
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Telephone | 440-734-5662
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Fax | 440-734-0989
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Authorized Official
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Title or Position | PRESIDENT
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Name | DEBRA L. THORNTON
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Credential | D.P.M.
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Telephone | 440-734-5662
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 2390
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License Number State | OH
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