Organization
ROBERT A FASBENDER
Active
Other names
Michaels Shoes
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT ANTHONY FASBENDER (OWNER SHOE & ORTHODIC FITTER)
(712) 792-3115
Entity
Organization
Contact information
Practice address
215 WEST 4TH STREET, CARROLL, IA 51401-2715
(712) 792-3115
(712) 792-3115
Mailing address
215 WEST 4TH STREET, CARROLL, IA 51401-2715
(712) 792-3115
(712) 792-3115
Taxonomy
Speciality
Code
Description
License number
State
225000000X
Orthotic Fitter
Primary
—
—
335E00000X
Prosthetic/Orthotic Supplier
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0034538
—
IA
Enumeration date
12/20/2006
Last updated
07/17/2008
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