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General NPI Number Information
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NPI Number | 1649678996
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Entity Type | Organization
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Legal Business Name | PERFORMANCE FOOT & ANKLE, LLC
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Dates
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Enumeration Date | 12/17/2014
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Last Update Date | 12/09/2025
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Provider Practice Location Address
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Address Line | 890 WOOSTER RD
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City | MILLERSBURG
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State | OH
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Zip | 44654-1033
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Country | US
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Telephone | 330-473-1447
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Fax | 330-473-1520
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Provider Business Mailing Address
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Address Line | 890 WOOSTER RD
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City | MILLERSBURG
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State | OH
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Zip | 44654-1033
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Country | US
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Telephone | 330-473-1447
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Fax | 330-473-1520
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Authorized Official
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Title or Position | MEMBER
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Name | NICOLE HORN
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Credential | DPM
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Telephone | 330-473-1447
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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 | 36.003427
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License Number State | OH
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