| NPI | 1437402013 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH WARREN Sole Member 216-577-7754 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP1100X Clinic/Center, Podiatric (Licence: ME 1084) |
| Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: TX 1880) |
| Enumeration Date | 2012-10-19 |
| Last Update Date | 2013-09-06 |