Organization
CANTILEVER SHOE STORES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JEAN S SEARS CERTIFIED PEDORTHIST (PRESIDENT OWNER)
(504) 454-2888
Entity
Organization
Contact information
Practice address
3429 HOUMA BLVD, METAIRIE, LA 70006-4225
(504) 454-2888
(504) 454-2889
Mailing address
3429 HOUMA BLVD, METAIRIE, LA 70006-4225
(504) 454-2888
(504) 454-2889
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1039969
—
LA
01
—
29844
BLUE CROSS BLUE SHIELD
LA
Enumeration date
07/17/2006
Last updated
04/25/2012
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