Ye Olde Cobbler
NPI #1700076585 in Wilsonville, Oregon
Provider Information
- NPI Number
- 1700076585
- Entity Type
- Organization
- Organization Name
- Ye Olde Cobbler
- Primary Specialty
- Durable Medical Equipment & Medical Supplies - Customized Equipment
- Enumeration Date
- Jul 27, 2007
- Last Updated
- Jan 17, 2008
Practice Location
- Address
- 30605 SW MAGNOLIA AVE
- City
- Wilsonville
- State
- Oregon
- ZIP Code
- 97070-6757
- Phone
- (503) 682-0354
Authorized Official
- Name
- RICHARD A FILONCZUK
- Title
- OWNER/ OPERATOR
- Phone
- (503) 682-0354
Specialties & Taxonomy Codes
| Specialty |
|---|
| Durable Medical Equipment & Medical Supplies - Customized Equipment — Customized Equipment |
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