Organization
VAGABOND SHOES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KATHLEEN M KELNHOFER (OWNER)
(920) 606-0163
Entity
Organization
Contact information
Practice address
635 BAY PARK SQ, GREEN BAY, WI 54304-5101
(920) 606-0163
(920) 498-2429
Mailing address
635 BAY PARK SQ, GREEN BAY, WI 54304-5101
(920) 606-0163
(920) 498-2429
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
WI
Other
Enumeration date
09/23/2006
Last updated
08/22/2020
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