Organization
ANKLE AND FOOT CARE CENTERS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAWRENCE DIDOMENICO DPM (DPM)
(330) 758-8808
Entity
Organization
Contact information
Practice address
16844 SAINT CLAIR AVE, EAST LIVERPOOL, OH 43920-4277
(330) 385-2413
Mailing address
16844 SAINT CLAIR AVE, EAST LIVERPOOL, OH 43920-4277
(330) 385-2413
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0008879000
—
WV
05
—
001496124-0001
—
PA
05
—
001496124-0004
—
PA
05
—
001496124-0005
—
PA
05
—
0102758
—
OH
01
—
5504
RAILROAD MEDICARE
OH
Enumeration date
06/11/2006
Last updated
12/12/2007
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