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General NPI Number Information
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NPI Number | 1649437872
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Entity Type | Organization
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Legal Business Name | COSHOCTON COUNTY FOOT & ANKLE CENTER, INC
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Dates
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Enumeration Date | 05/16/2008
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Last Update Date | 01/30/2019
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Provider Practice Location Address
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Address Line | 1100 FAIRY FALLS DR SUITE 5
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City | COSHOCTON
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State | OH
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Zip | 43812-2803
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Country | US
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Telephone | 740-622-0338
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Fax | 888-730-2212
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Provider Business Mailing Address
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Address Line | 1100 FAIRY FALLS DR SUITE 5
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City | COSHOCTON
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State | OH
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Zip | 43812-2803
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Country | US
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Telephone | 740-622-0338
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Fax | 888-730-2212
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. KATIE L LITSEY
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Credential |
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Telephone | 740-622-0338
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number | 2656
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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License Number | 2656
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License Number State | OH
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