Provider Demographics
NPI:1649568635
Name:COMPLETE FOOT CARE LLC
Entity Type:Organization
Organization Name:COMPLETE FOOT CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:J
Authorized Official - Last Name:BERKOWITZ
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:440-735-3338
Mailing Address - Street 1:88 CENTER RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:BEDFORD
Mailing Address - State:OH
Mailing Address - Zip Code:44146-2700
Mailing Address - Country:US
Mailing Address - Phone:440-735-3338
Mailing Address - Fax:440-735-8234
Practice Address - Street 1:88 CENTER RD
Practice Address - Street 2:SUITE 100
Practice Address - City:BEDFORD
Practice Address - State:OH
Practice Address - Zip Code:44146-2700
Practice Address - Country:US
Practice Address - Phone:440-735-3338
Practice Address - Fax:440-735-8234
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-12
Last Update Date:2011-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH36-001803213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot SurgeryGroup - Single Specialty