Organization
COLONIAL FOOT & ANKLE CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESS MOORE (OFFICE MANAGER)
(740) 653-2656
Entity
Organization
Contact information
Practice address
121 N EWING ST, LANCASTER, OH 43130-3364
(740) 653-2656
(740) 687-0300
Mailing address
121 N EWING ST, LANCASTER, OH 43130-3364
(740) 653-2656
(740) 687-0300
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2587204
—
OH
01
—
DE6505
RAILROAD MEDICARE
OH
Enumeration date
01/03/2006
Last updated
03/24/2014
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