Individual
MR. MICHAEL FRACASSA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
1641 VENTURE DRIVE, MOUNT VERNON, OH 43050-7001
(740) 393-3338
(740) 393-1138
Mailing address
PO BOX 27940, 3255 E LIVINGSTON AVE, COLUMBUS, OH 43227
(614) 239-0399
(614) 239-6374
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
36002245
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0560147
—
OH
Enumeration date
07/26/2006
Last updated
08/17/2021
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