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Organization
HUDSON FOOT CLINIC, INC.
Active
Organization
HUDSON FOOT CLINIC, INC.
Active
Other names
Western Reserve Foot Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENNETH HARLEY NIXON D.P.M. (PRESIDENT)
(330) 689-3338
Entity
Organization
Contact information
Practice address
4495 DARROW RD, STOW, OH 44224-1854
(330) 689-3338
(330) 689-0282
Mailing address
4495 DARROW RD, STOW, OH 44224-1854
(330) 689-3338
(330) 689-0282
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
36-00-2719
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2915742
—
OH
01
—
480016282
MEDICARE RAILROAD
OH
Enumeration date
04/16/2007
Last updated
04/23/2009
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