| NPI | 1669573416 |
|---|---|
| Doing Business As | INTERMOUNTAIN THERAPEUTIC SHOES |
| Entity Type | Organization |
| Authorized Contact | CHRYSTINE HENDRICKS Manager Authorized Official 208-522-6433 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2012-03-22 |