Organization
LEBO'S SHOE STORE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN GOLDSMITH (FOOT SPECIALIST)
(704) 641-4243
Entity
Organization
Contact information
Practice address
7300 E INDEPENDENCE BLVD, CHARLOTTE, NC 28227-9400
(704) 535-5000
Mailing address
2321 CROWN CENTRE DR, CHARLOTTE, NC 28227-7705
(704) 321-5000
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
09/24/2008
Last updated
09/24/2008
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