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General NPI Number Information
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NPI Number | 1740488048
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Entity Type | Organization
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Legal Business Name | SHOE SOLUTIONS INC.
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Dates
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Enumeration Date | 07/07/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2152 SADLER RD SUITE 20
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City | FERNANDINA BEACH
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State | FL
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Zip | 32034-4451
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Country | US
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Telephone | 904-261-6886
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Fax |
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Provider Business Mailing Address
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Address Line | 3100 SEA MARSH RD
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City | FERNANDINA BEACH
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State | FL
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Zip | 32034-5051
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Country | US
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Telephone | 904-491-1441
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Fax | 904-491-1441
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. DON JAMES HUNTER
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Credential | PT, L.PED
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Telephone | 904-614-0046
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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 | PED87 PT2669
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License Number State | FL
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