Organization
PRESTIGE FOOT & ANKLE CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MACHELLE GIORDON (CREDENTIALING SPECIALIST)
(330) 723-2111
Entity
Organization
Contact information
Practice address
5655 HUDSON DR, STE 315, HUDSON, OH 44236-4451
(330) 591-9635
(330) 591-4150
Mailing address
784 MEDINA RD, 107, MEDINA, OH 44256-9634
(330) 591-9635
(330) 591-4150
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
36003592
OH
Other
Enumeration date
02/20/2014
Last updated
02/20/2014
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