Organization
FOOTPRINTS FASHION FOOTWEAR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SCOTT D COHEN (VICE PRESIDENT)
(860) 666-3100
Entity
Organization
Contact information
Practice address
79 COSTELLO RD, NEWINGTON, CT 06111-5109
(860) 666-3100
(860) 594-0705
Mailing address
79 COSTELLO RD, NEWINGTON, CT 06111-5109
(860) 666-3100
(860) 594-0705
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
05/20/2006
Last updated
08/22/2020
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