| |
144 Larimar Dr, Willowick, OH 44095-5212 | |
(216) 229-0292 | |
(440) 975-1963 |
Full Name | |
---|---|
Type | Facility |
Speciality | Podiatrist - Primary Podiatric Medicine |
Location | 144 Larimar Dr, Willowick, Ohio |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1609146240 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
213EP1101X | Podiatrist - Primary Podiatric Medicine | 36003068 (Ohio) | Primary |
Mailing Address | Practice Location Address |
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Po Box 182, Wickliffe, OH 44092-0182 Ph: (216) 229-0292 | 144 Larimar Dr, Willowick, OH 44095-5212 Ph: (216) 229-0292 |
Kelly Rader Whaley, DPM Podiatrist Medicare: Medicare Enrolled Practice Location: 144 Larimar Dr, Willowick, OH 44095 Phone: 216-229-0292 Fax: 440-975-1963 |