Organization
FREMONT SHOE REPAIR TRU FIT PEDORTHICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHARLES THOMAS DEKRYGER C. PED. (PRESIDENT)
(231) 924-0222
Entity
Organization
Contact information
Practice address
124 S STEWART AVE, FREMONT, MI 49412-1624
(231) 924-0222
(231) 924-3855
Mailing address
124 S STEWART AVE, FREMONT, MI 49412-1624
(231) 924-0222
(231) 924-3855
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
MI
Other
Enumeration date
03/14/2007
Last updated
08/22/2020
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