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Lori Mcnickle, CPED,RFOM
Pedorthist in Canton, Ohio
NPI 1861733396

Lori Mcnickle is a Pedorthist based in Canton, OH. Lori Mcnickle practices in Canton, OH and has the professional credentials of CPED,RFOM. The NPI Number for Lori Mcnickle is 1861733396 and holds a License No. LPED32 (Ohio).

The current practice location address for Lori Mcnickle is 4663 Whipple Ave Nw, Canton, OH and can be reached out via phone at 330-479-0020 and via fax at 330-493-5759.

Location: 4663 Whipple Ave Nw, Canton, OH, 44718-2615
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1861733396
Provider Name
Lori Mcnickle
Credential
CPED,RFOM
Provider Entity Type
Individual
Gender
Female
Address
4663 Whipple Ave Nw, Canton, OH, 44718-2615
Phone Number
330-479-0020
Fax Number
330-493-5759
Provider Enumeration Date
03/07/2013
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
2002862 05 OH
institution
Provider Business Practice Location Address Details
Address
4663 Whipple Ave Nw
City
Canton
State
Ohio
Zip
44718-2615
Phone Number
330-479-0020
Fax Number
330-493-5759
person
Provider Business Mailing Address Details
Address
4663 Whipple Ave Nw
City
Canton
State
Ohio
Zip
44718-2615
Phone Number
330-479-0020
Fax Number
330-493-5759
person
Provider's Taxonomy Details 1
Type
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Classification
Pedorthist
Speciality
-
Taxonomy
224L00000X
License No.
LPED32 (Ohio)
Definition
An individual who is trained in the management and treatment of conditions of the foot, ankle, and lower extremities requiring fitting, fabricating, and adjusting of pedorthic devices.
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