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General NPI Number Information
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NPI Number | 1801133194
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Entity Type | Organization
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Legal Business Name | SHOES & THINGS
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Dates
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Enumeration Date | 01/07/2013
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Last Update Date | 01/07/2013
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Provider Practice Location Address
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Address Line | 323 N D ST
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City | PORTERVILLE
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State | CA
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Zip | 93257-3629
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Country | US
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Telephone | 559-782-3472
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Fax |
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Provider Business Mailing Address
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Address Line | 323 N D ST
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City | PORTERVILLE
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State | CA
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Zip | 93257-3629
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Country | US
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Telephone | 559-782-3472
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Fax |
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Authorized Official
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Title or Position | CERTIFIED PEDORTHIST
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Name | DEANNA L JACKSON
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Credential | CPED
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Telephone | 559-736-3193
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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 |
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