Provider Demographics
NPI:1700313400
Name:FOOT & ANKLE ASSOCIATES OF CLEVELAND, LLC
Entity Type:Organization
Organization Name:FOOT & ANKLE ASSOCIATES OF CLEVELAND, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:
Authorized Official - Last Name:FREY
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:440-903-1041
Mailing Address - Street 1:33790 BAINBRIDGE RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44139-2947
Mailing Address - Country:US
Mailing Address - Phone:440-903-1041
Mailing Address - Fax:
Practice Address - Street 1:33790 BAINBRIDGE RD
Practice Address - Street 2:SUITE 201
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44139-2947
Practice Address - Country:US
Practice Address - Phone:440-903-1041
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-12
Last Update Date:2017-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty