| NPI | 1497812002 |
|---|---|
| Doing Business As | COREY'S BOOTERY |
| Entity Type | Organization |
| Authorized Contact | JEFF DAVIS President 269-349-2247 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier |
| Enumeration Date | 2007-01-02 |
| Last Update Date | 2020-08-22 |