| NPI | 1871745653 |
|---|---|
| Doing Business As | THE ACTIVE FOOT STORE |
| Entity Type | Organization |
| Authorized Contact | PHILIP LARKINS President 858-453-5057 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Enumeration Date | 2008-10-12 |
| Last Update Date | 2022-11-12 |