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Organization

ANKLE AND FOOT CARE CENTERS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LAWRENCE DIDOMENICO DPM (DPM)
(330) 629-8800
Entity
Organization

Contact information

Practice address
2380 SOUTHEAST BLVD, SALEM, OH 44460-3476
(330) 337-8870
Mailing address
2380 SOUTHEAST BLVD, SALEM, OH 44460-3476
(330) 337-8870

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0102758
OH
01
5504
RAILROAD MEDICARE
OH
Enumeration date
06/11/2006
Last updated
11/01/2007
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