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General NPI Number Information
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NPI Number | 1821198318
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Entity Type | Organization
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Legal Business Name | WILLIAM D TENNEY
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Dates
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Enumeration Date | 09/24/2006
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Last Update Date | 11/10/2011
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Provider Practice Location Address
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Address Line | 8899 MENTOR AVE
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City | MENTOR
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State | OH
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Zip | 44060-6211
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Country | US
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Telephone | 440-974-3338
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Fax |
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Provider Business Mailing Address
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Address Line | 8899 MENTOR AVE
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City | MENTOR
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State | OH
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Zip | 44060-6211
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Country | US
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Telephone | 440-974-3338
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. WILLIAM D. TENNEY
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Credential | D.P.M.
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Telephone | 440-974-3338
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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 | 36001599
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License Number State | OH
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