Jla Senior Footcare Oh PA LLC

NPI #1376859298 in Canfield, Ohio

Provider Information

NPI Number: 1376859298
Entity Type: Organization
Organization Name: Jla Senior Footcare Oh PA LLC
Primary Specialty: Podiatrist
Enumeration Date: Aug 30, 2010
Last Updated: Jun 24, 2011

Practice Location

Address: 6715 TIPPECANOE RD BLDG F
City: Canfield
State: Ohio
ZIP Code: 44406-8180
Phone: (330) 702-0978

Authorized Official

Name: ANTHONY E INNOCENZI, DPM
Title: OWNER
Phone: (330) 702-0978

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Podiatrist	213E00000X	Primary

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