Organization
MY FOOT RX LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT C MC ROBERTS JR. C.PED (OWNER)
(715) 568-1500
Entity
Organization
Contact information
Practice address
1706 YORK ST, UNIT #3, BLOOMER, WI 54724-1920
(715) 577-9098
Mailing address
1706 YORK ST STE 3, BLOOMER, WI 54724-1921
(715) 568-1500
(715) 568-1501
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
—
—
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
12/28/2016
Last updated
01/08/2018
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