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General NPI Number Information
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NPI Number | 1891815072
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Entity Type | Organization
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Legal Business Name | THERAPEUTIC FOOTWEAR, INC
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Dates
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Enumeration Date | 03/30/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 7501 CUSTER RD W
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City | LAKEWOOD
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State | WA
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Zip | 98499-8138
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Country | US
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Telephone | 253-473-4311
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Fax | 253-473-4408
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Provider Business Mailing Address
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Address Line | 7501 CUSTER RD W
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City | LAKEWOOD
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State | WA
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Zip | 98499-8138
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | RALPH L KENDALL
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Credential | C-PED
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Telephone | 253-473-4311
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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 | WA
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