| NPI | 1447427562 |
|---|---|
| Former Legal Business Name | HEALTHY FEET STORE |
| Entity Type | Organization |
| Authorized Contact | TERESA ANN BLACK Owner 817-377-3668 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: TX CPed1950) |
| Enumeration Date | 2008-05-08 |
| Last Update Date | 2011-11-15 |