| NPI | 1396950580 |
|---|---|
| Doing Business As | FOOT SPECIALISTS OF SHREVEPORT BOSSIER |
| Entity Type | Organization |
| Authorized Contact | KELLI A FULFORD Office Manager 318-213-3668 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Enumeration Date | 2007-05-11 |
| Last Update Date | 2008-06-19 |