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General NPI Number Information
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NPI Number | 1700827615
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Entity Type | Organization
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Legal Business Name | ANKLE AND FOOT CARE CENTERS
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Dates
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Enumeration Date | 06/10/2006
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Last Update Date | 12/12/2007
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Provider Practice Location Address
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Address Line | 136 N MARKET ST
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City | EAST PALESTINE
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State | OH
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Zip | 44413-2019
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Country | US
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Telephone | 330-385-2413
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Fax |
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Provider Business Mailing Address
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Address Line | 136 N MARKET ST
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City | EAST PALESTINE
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State | OH
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Zip | 44413-2019
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Country | US
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Telephone | 330-385-2413
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Fax |
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Authorized Official
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Title or Position | DPM
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Name | LAWRENCE DIDOMENICO
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Credential | DPM
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Telephone | 330-758-8808
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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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