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Organization
ELYRIA FOOT CLINIC INC.
Active
Organization
ELYRIA FOOT CLINIC INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GEORGE COSTARAS D.P.M. (PRESIDENT)
(440) 366-6029
Entity
Organization
Contact information
Practice address
1170 E BROAD ST, SUITE 104, ELYRIA, OH 44035-6351
(440) 366-6029
(440) 366-6064
Mailing address
1170 E BROAD ST, SUITE 104, ELYRIA, OH 44035-6351
(440) 366-6029
(440) 366-6064
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
—
NULL
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
—
—
Other
Enumeration date
01/17/2006
Last updated
05/11/2010
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