| NPI | 1225874175 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THERESA M FAUVER Manager 440-357-8418 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213E00000X Podiatrist |
| Additional Taxonomies | 261QP1100X Clinic/Center, Podiatric |
| Enumeration Date | 2024-07-01 |
| Last Update Date | 2024-07-01 |