Organization
MADISON LEE PODIATRY, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT THOMAS PORTNOW D.P.M. (PRESIDENT)
(216) 631-6080
Entity
Organization
Contact information
Practice address
6502 DETROIT AVE, CLEVELAND, OH 44102-3014
(216) 631-6080
(216) 651-5002
Mailing address
6502 DETROIT AVE, CLEVELAND, OH 44102-3014
(216) 631-6080
(216) 651-5002
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
2576
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2245814
—
OH
Enumeration date
05/28/2010
Last updated
07/01/2010
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