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Organization

STANLEY LUKSENBURG

Active
Other names
Fairview Podiatry Clinic
Organization subpart
No

Provider details

NPI number
Authorized official
DR. STANLEY A LUKSENBURG DPM (OWNER)
(440) 356-1118
Entity
Organization

Contact information

Practice address
21475 LORAIN RD, FAIRVIEW PARK, OH 44126-2124
(440) 356-1118
Mailing address
21475 LORAIN RD, FAIRVIEW PARK, OH 44126-2124
(440) 356-1118

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
36002120
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0577620
OH
Enumeration date
06/16/2007
Last updated
06/24/2008
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