Provider Demographics
NPI:1871040139
Name:ASSOCIATES FAMILY FOOT CARE
Entity Type:Organization
Organization Name:ASSOCIATES FAMILY FOOT CARE
Other - Org Name:GARRETTSVILLE FOOT AND ANKLE CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:CARMELITA
Authorized Official - Middle Name:R
Authorized Official - Last Name:REYES
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:330-759-8690
Mailing Address - Street 1:PO BOX 128
Mailing Address - Street 2:
Mailing Address - City:GIRARD
Mailing Address - State:OH
Mailing Address - Zip Code:44420-0128
Mailing Address - Country:US
Mailing Address - Phone:330-527-4088
Mailing Address - Fax:330-527-4089
Practice Address - Street 1:8307 WINDHAM ST
Practice Address - Street 2:SUITE 2
Practice Address - City:GARRETTSVILLE
Practice Address - State:OH
Practice Address - Zip Code:44231-9406
Practice Address - Country:US
Practice Address - Phone:330-527-4088
Practice Address - Fax:330-527-4089
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-04
Last Update Date:2016-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty