# TAYLORED SHOES

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1184993941
- **Authorized official:** KEITH TAYLOR (OWNER/C.PED)
- **Authorized official phone:** (707) 290-0627

## Contact information

- **Practice address:** 1025 5TH ST, NOVATO, CA 94945-2413
- **Practice address phone:** (707) 290-0627
- **Mailing address:** 2401 WATERMAN BLVD, STE 4A, FAIRFIELD, CA 94534-1800

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | Yes |

## Other

- **Enumeration date:** 12/23/2011
- **Last updated:** 02/16/2012