MR. Antonio Mario Sergio SR., REG SHOE-MAKER MERCH
NPI #1437301074 in South Bend, Indiana
Provider Information
- NPI Number
- 1437301074
- Entity Type
- Individual
- Name
- MR. Antonio Mario Sergio SR., REG SHOE-MAKER MERCH
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Orthotist
- Credential
- REG SHOE-MAKER MERCH
- Enumeration Date
- Oct 15, 2008
- Last Updated
- Oct 15, 2008
Practice Location
- Address
- 1508 MISHAWAKA AVENUE
- City
- South Bend
- State
- Indiana
- ZIP Code
- 46615-1426
- Phone
- (574) 246-9700
Specialties & Taxonomy Codes
| Specialty |
|---|
| Orthotist |
| Orthotic Fitter |
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