| NPI | 1770625857 |
|---|---|
| Doing Business As | THE ACTIVE FOOT STORE |
| Entity Type | Organization |
| Authorized Contact | JACK A REINGOLD President 858-792-1142 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Enumeration Date | 2007-02-13 |
| Last Update Date | 2008-05-08 |