Organization
ANKLE AND FOOT CARE CENTERS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAWRENCE DIDOMENICO (DPM)
(330) 629-8800
Entity
Organization
Contact information
Practice address
17674 MAHONING AVE, LAKE MILTON, OH 44429-9582
(330) 654-2511
Mailing address
17674 MAHONING AVE, LAKE MILTON, OH 44429-9582
(330) 654-2511
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0102758
—
OH
01
—
5504
RAILROAD MEDICARE
OH
Enumeration date
08/07/2006
Last updated
11/01/2007
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