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General NPI Number Information
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NPI Number | 1508808395
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Entity Type | Organization
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Legal Business Name | ASHLAND/MANSFIELD FOOT & ANKLE SPECIALISTS
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Dates
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Enumeration Date | 06/13/2006
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Last Update Date | 03/11/2015
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Provider Practice Location Address
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Address Line | 550 S TRIMBLE RD
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City | MANSFIELD
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State | OH
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Zip | 44906-3418
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Country | US
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Telephone | 419-756-1961
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Fax | 419-774-9145
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Provider Business Mailing Address
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Address Line | PO BOX 22958
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City | CLEVELAND
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State | OH
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Zip | 44122-0958
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Country | US
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Telephone | 216-595-9600
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Fax | 216-595-9601
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Authorized Official
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Title or Position | PRESIDENT
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Name | LARRY J ZIMMERMAN
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Credential | D. P.M.
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Telephone | 419-756-1961
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number |
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License Number State |
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