Organization
MOONEYS SHOES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAN CALVIN WILLIAMS CERTIFIED PEDORTHIST (OWNER)
(706) 722-8773
Entity
Organization
Contact information
Practice address
2825 WASHINGTON RD, G-2, AUGUSTA, GA 30909-2196
(706) 722-8773
(706) 722-1227
Mailing address
2825 WASHINGTON RD, G-2, AUGUSTA, GA 30909-2196
(706) 722-8773
(706) 722-1227
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
—
GA
Other
Enumeration date
01/31/2007
Last updated
05/31/2011
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