| NPI | 1487925004 |
|---|---|
| Doing Business As | OLDE SOLES COBBLER SHOP |
| Entity Type | Organization |
| Authorized Contact | BRIAN T. DI GIULIO Owner 856-216-8003 |
| Organization Subpart ? | No |
| Primary Taxonomy | 224L00000X (Licence: NJ C46786) |
| Additional Taxonomies | 225000000X Orthotic Fitter (Licence: NJ C46786) |
| 332B00000X Durable Medical Equipment & Medical Supplies (Licence: NJ C46786) | |
| Enumeration Date | 2012-01-13 |
| Last Update Date | 2012-01-13 |