2nd Sole-Custom Shoes & Orthotics, INC
NPI #1841321403 in Paradise, California
Provider Information
- NPI Number
- 1841321403
- Entity Type
- Organization
- Organization Name
- 2nd Sole-Custom Shoes & Orthotics, INC
- Primary Specialty
- Durable Medical Equipment & Medical Supplies - Customized Equipment
- Enumeration Date
- Mar 8, 2007
- Last Updated
- Jan 5, 2015
Practice Location
- Address
- 5923 CLARK RD
- Address 2
- SUITE C
- City
- Paradise
- State
- California
- ZIP Code
- 95969-4866
- Phone
- (530) 872-3710
Authorized Official
- Name
- BRADY BENJAMIN ELLIOTT, C.PED, CFO
- Title
- VICE-PRESIDENT
- Phone
- (530) 872-3710
Specialties & Taxonomy Codes
| Specialty |
|---|
| Durable Medical Equipment & Medical Supplies - Customized Equipment — Customized Equipment |
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