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General NPI Number Information
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NPI Number | 1851413371
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Entity Type | Organization
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Legal Business Name | LUKES ULTIMATE COMFORT SHOES INC.
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Dates
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Enumeration Date | 04/04/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3419 STATE ST
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City | SANTA BARBARA
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State | CA
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Zip | 93105-2625
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Country | US
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Telephone | 805-687-2696
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Fax | 805-687-8261
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Provider Business Mailing Address
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Address Line | 3419 STATE ST
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City | SANTA BARBARA
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State | CA
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Zip | 93105-2625
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Country | US
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Telephone | 805-687-2696
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Fax | 805-687-8261
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Authorized Official
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Title or Position | PRESIDENT-CEO
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Name | BRYAN K THOMAS
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Credential |
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Telephone | 805-687-2696
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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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