Organization
JOHNS ORTHOPEDIC & SHOE REPAIR LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN T URRUTIA C. PED. (SOLE MBR/OWNER)
(201) 339-8750
Entity
Organization
Contact information
Practice address
929 BROADWAY, BAYONNE, NJ 07002-3050
(201) 339-8750
(201) 455-2606
Mailing address
929 BROADWAY, BAYONNE, NJ 07002-3050
(201) 339-8750
(201) 455-2606
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8087202
—
NJ
Enumeration date
01/18/2007
Last updated
08/17/2015
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