Individual
STACIE DYAN ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DPM
Contact information
Practice address
5625 RIDGE RD, PARMA, OH 44129-2633
(440) 884-4100
(440) 884-4742
Mailing address
5625 RIDGE RD, PARMA, OH 44129-2633
(440) 884-4100
(440) 884-4742
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
36.003622
OH
Other
Enumeration date
06/06/2011
Last updated
06/06/2012
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