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General NPI Number Information
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NPI Number | 1699980276
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Entity Type | Organization
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Legal Business Name | EXECUTIVE FOOT CENTER INC
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Dates
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Enumeration Date | 05/14/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 5520 BROADVIEW RD
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City | PARMA
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State | OH
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Zip | 44134-1605
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Country | US
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Telephone | 800-379-0398
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Fax |
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Provider Business Mailing Address
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Address Line | 3650 SEVERN RD
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City | CLEVELAND HTS
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State | OH
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Zip | 44118-1907
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Country | US
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Telephone | 800-379-0398
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Fax | 216-932-9991
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. EZRIEL ZELIG SCHUR
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Credential | DPM
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Telephone | 800-379-0398
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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 | 36002038
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License Number State | OH
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