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General NPI Number Information
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NPI Number | 1093887564
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Entity Type | Organization
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Legal Business Name | WHEN THE SHOE FITS
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Dates
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Enumeration Date | 11/14/2006
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Last Update Date | 03/27/2008
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Provider Practice Location Address
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Address Line | 7060 VALLEY CREEK PLZ SUITE 113
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City | WOODBURY
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State | MN
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Zip | 55125-2269
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Country | US
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Telephone | 651-739-3668
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Fax | 651-739-3678
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Provider Business Mailing Address
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Address Line | 7060 VALLEY CREEK PLZ SUITE 113
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City | WOODBURY
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State | MN
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Zip | 55125-2269
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Country | US
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Telephone | 651-739-3668
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Fax | 651-739-3678
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Authorized Official
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Title or Position | OWNER
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Name | CONNIE TARY
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Credential |
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Telephone | 651-739-3668
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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