Provider Demographics
NPI:1366879850
Name:FEENEY, JOSEPH E III (LMT)
Entity type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:E
Last Name:FEENEY
Suffix:III
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4556 HARDING ST
Mailing Address - Street 2:
Mailing Address - City:BRUNSWICK
Mailing Address - State:OH
Mailing Address - Zip Code:44212-3318
Mailing Address - Country:US
Mailing Address - Phone:216-903-7671
Mailing Address - Fax:
Practice Address - Street 1:5788 RIDGE RD
Practice Address - Street 2:SUITE 2
Practice Address - City:PARMA
Practice Address - State:OH
Practice Address - Zip Code:44129-3168
Practice Address - Country:US
Practice Address - Phone:440-882-6985
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-30
Last Update Date:2013-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH020788171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor