Organization
SECOND SOLE SHOE REPAIR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. HENRY MOHLER BOYD (OWNER)
(610) 664-0770
Entity
Organization
Contact information
Practice address
99 E CITY LINE AVE, SECOND SOLE SHOE REPAIR BALA CYNWYD SHOPPING CTR, BALA CYNWYD, PA 19004
(610) 664-0770
Mailing address
99 E CITY LINE AVE, SECOND SOLE SHOE REPAIR BALA CYNWYD SHOPPING CTR, BALA CYNWYD, PA 19004
(610) 664-0770
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
11/28/2006
Last updated
06/17/2008
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