Organization
TRIAD FOOT AND ANKLE SPECIALISTS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY J. SIESEL DPM (PRESIDENT)
(216) 226-9108
Entity
Organization
Contact information
Practice address
15644 MADISON AVE, SUITE 217, LAKEWOOD, OH 44107-5622
(216) 226-9108
(216) 226-9108
Mailing address
PO BOX 93, NORTH OLMSTED, OH 44070-0093
(440) 777-6017
(440) 777-6940
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DA5380
RR MEDICARE
—
Enumeration date
01/05/2006
Last updated
03/10/2008
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