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General NPI Number Information
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NPI Number | 1043296908
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Entity Type | Organization
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Legal Business Name | FLETCHERS SHOES INC
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Dates
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Enumeration Date | 12/21/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2221 HILLSBORO RD
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City | FRANKLIN
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State | TN
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Zip | 37069-6200
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Country | US
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Telephone | 615-790-3610
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Fax | 615-790-2721
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Provider Business Mailing Address
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Address Line | 2221 HILLSBORO RD
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City | FRANKLIN
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State | TN
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Zip | 37069-6200
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Country | US
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Telephone | 615-790-3610
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Fax | 615-790-2721
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | MR. GRADY B FLETCHER
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Credential | PEDORTHIST
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Telephone | 615-790-3610
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number |
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License Number State | TN
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