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General NPI Number Information
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NPI Number | 1356461461
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Entity Type | Organization
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Legal Business Name | FOOTWISE COMFORT SHOES
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Dates
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Enumeration Date | 03/30/2007
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Last Update Date | 11/19/2008
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Provider Practice Location Address
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Address Line | 7114 HIGHWAY 70 S SUITE 109
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City | NASHVILLE
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State | TN
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Zip | 37221-2981
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Country | US
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Telephone | 615-662-1300
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Fax | 615-662-1326
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Provider Business Mailing Address
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Address Line | 7114 HIGHWAY 70 S SUITE 109
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City | NASHVILLE
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State | TN
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Zip | 37221-2981
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Country | US
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Telephone | 615-662-1300
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Fax | 615-662-1326
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Authorized Official
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Title or Position | OWNER
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Name | ORLY COHEN
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Credential | C.PED.
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Telephone | 615-662-1300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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License Number |
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License Number State |
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