Gollihar's Shoe Store, Inc.
NPI #1255442331 in Versailles, Missouri
Provider Information
- NPI Number
- 1255442331
- Entity Type
- Organization
- Organization Name
- Gollihar's Shoe Store, Inc.
- Primary Specialty
- Prosthetic/Orthotic Supplier
- Enumeration Date
- Aug 31, 2006
- Last Updated
- Aug 22, 2020
Practice Location
- Address
- 105 N MONROE ST
- City
- Versailles
- State
- Missouri
- ZIP Code
- 65084-1216
- Phone
- (573) 378-4652
Authorized Official
- Name
- MR. LARRY ALLEN CLARK, CERTIFIED PEDORTHIST
- Title
- PRESIDENT
- Phone
- (573) 378-4652
Specialties & Taxonomy Codes
| Specialty |
|---|
| Prosthetic/Orthotic Supplier |
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