Organization
FOOTSTAR PEDORTHIC CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MATTHEW ARCIVOLO (OWNER)
(800) 318-0007
Entity
Organization
Contact information
Practice address
74 BROAD ST, MILFORD, CT 06460-3353
(800) 318-0007
Mailing address
74 BROAD ST, MILFORD, CT 06460-3353
(800) 318-0007
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
2391
CT
Other
Enumeration date
05/11/2010
Last updated
05/11/2010
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