# KETTERING PODIATRY ASSOCIATES LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1083630693
- **Authorized official:** DR. LANCING P MALUSKY DPM (OWNER/PRESIDENT)
- **Authorized official phone:** (937) 293-6896

## Contact information

- **Practice address:** 15 SOUTHMOOR CIR NE, KETTERING, OH 45429-2451
- **Practice address phone:** (937) 293-6896
- **Practice address fax:** (937) 293-9150
- **Mailing address:** 15 SOUTHMOOR CIR NE, KETTERING, OH 45429-2451
- **Mailing address phone:** (937) 293-6896
- **Mailing address fax:** (937) 293-9150

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | — | NULL | Yes |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | — | — | Yes |

## Other

- **Enumeration date:** 07/15/2006
- **Last updated:** 11/13/2014

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 2748683 | — | OH |