Organization
THE FOOT AND ANKLE CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTINA M KOVACH DPM (OWNER)
(216) 227-2194
Entity
Organization
Contact information
Practice address
1730 W 25TH ST, 2E, CLEVELAND, OH 44113-3108
(216) 227-2194
(216) 227-2196
Mailing address
PO BOX 80690, CANTON, OH 44708-0690
(330) 833-5692
(330) 833-6085
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
36002928
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2035158
—
OH
Enumeration date
03/15/2007
Last updated
01/24/2008
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