Healthcare Provider Details

I. General information

NPI: 1912373879
Provider Name (Legal Business Name): CURRY'S SHOES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/14/2015
Last Update Date: 08/14/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2535 NICHOLASVILLE RD STE 120
LEXINGTON KY
40503-3364
US

IV. Provider business mailing address

2535 NICHOLASVILLE RD STE 120
LEXINGTON KY
40503-3364
US

V. Phone/Fax

Practice location:
  • Phone: 859-278-7411
  • Fax: 859-277-7777
Mailing address:
  • Phone: 859-278-7411
  • Fax: 859-224-1399

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225000000X
TaxonomyOrthotic Fitter
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VIII. Authorized Official

Name: MR. TODD E. STOCKWELL
Title or Position: PRESIDENT
Credential:
Phone: 859-223-3400