Organization
THERAPEUTIC SHOES INC
Active
Organization
THERAPEUTIC SHOES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES CALL III DPM (PRESIDENT)
(208) 524-1995
Entity
Organization
Contact information
Practice address
718 BEULAHS LANE, IDAHO FALLS, ID 83401
(208) 524-1995
(208) 524-1995
Mailing address
718 BEULAHS LANE, IDAHO FALLS, ID 83401
(208) 524-1995
(208) 524-1995
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
P085
ID
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1350425
—
ID
01
—
82505
ANTHEM
—
01
—
P0854
BC
—
Enumeration date
06/03/2006
Last updated
08/11/2008
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