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Organization

BROWN'S SHOE FIT CO

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MARK THOMAS NEBEL (MANAGER/OWNER)
(641) 472-2758
Entity
Organization

Contact information

Practice address
1702 W BURLINGTON AVE, FAIRFIELD, IA 52556-2617
(641) 472-2758
(641) 469-5099
Mailing address
1702 W BURLINGTON AVE, FAIRFIELD, IA 52556-2617
(641) 472-2758
(641) 469-5099

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
X000203558
IA
Enumeration date
02/11/2009
Last updated
02/11/2009
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