| NPI | 1194078816 |
|---|---|
| Doing Business As | PARKWAY SHOE REPAIR SERVICE |
| Entity Type | Organization |
| Authorized Contact | VIVIAN LEA MARTIN Owner 618-242-4442 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier |
| Enumeration Date | 2012-10-18 |
| Last Update Date | 2012-10-18 |