Organization
ITALY SHOES AND BOUTIQUE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SANDY SOO CHUN (MANAGER)
(562) 860-4634
Entity
Organization
Contact information
Practice address
11815 SOUTH ST, CERRITOS, CA 90703-6825
(562) 860-4634
(562) 860-5109
Mailing address
11815 SOUTH ST, CERRITOS, CA 90703-6825
(562) 860-4634
(562) 860-5109
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
12/06/2007
Last updated
12/06/2007
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