Organization
FOOTWISE COMFORT SHOES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ORLY COHEN C.PED. (OWNER)
(615) 662-1300
Entity
Organization
Contact information
Practice address
7114 HIGHWAY 70 S, SUITE 109, NASHVILLE, TN 37221-2981
(615) 662-1300
(615) 662-1326
Mailing address
7114 HIGHWAY 70 S, SUITE 109, NASHVILLE, TN 37221-2981
(615) 662-1300
(615) 662-1326
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1544047
—
TN
01
—
4116958
BCBS OF TN
TN
Enumeration date
03/30/2007
Last updated
11/19/2008
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