| NPI | 1831887066 |
|---|---|
| Doing Business As | LAURIES SHOES |
| Entity Type | Organization |
| Authorized Contact | TEENA MCADAMS Accounting 314-604-2154 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 305R00000X Preferred Provider Organization |
| Enumeration Date | 2023-04-26 |
| Last Update Date | 2023-04-26 |