Organization
ATTA J ASEF DPM LTD
Active
Other names
Lake Podiatry
Organization subpart
No
Provider details
NPI number
Authorized official
ATTA ASEF DPM (OWNER)
(440) 953-1003
Entity
Organization
Contact information
Practice address
35010 CHARDON RD, 101A, WILLOUGHBY HILLS, OH 44094-9010
(440) 953-1003
(440) 953-3556
Mailing address
36001 EUCLID AVE, WILLOUGHBY, OH 44094-4643
(440) 953-1003
(440) 953-3556
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
36002887A
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2085023
—
OH
05
—
3025514
—
OH
Enumeration date
11/06/2007
Last updated
12/14/2011
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