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General NPI Number Information
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NPI Number | 1194165563
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Entity Type | Organization
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Legal Business Name | BARBERTON PODIATRY, INC
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Dates
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Enumeration Date | 07/01/2013
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Last Update Date | 03/22/2016
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Provider Practice Location Address
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Address Line | 200 1ST ST NW SUITE 2
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City | BARBERTON
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State | OH
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Zip | 44203-2555
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Country | US
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Telephone | 330-753-7772
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Fax |
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Provider Business Mailing Address
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Address Line | 200 1ST ST NW SUITE 2
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City | BARBERTON
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State | OH
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Zip | 44203-2555
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Country | US
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Telephone | 330-753-7772
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. GINA TOMSHO
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Credential | DPM
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Telephone | 330-753-7772
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | 36003668
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License Number State | OH
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