Organization
WALK EASY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ANTHONY B CHARLES CERTIFIED PEDORTHIST (OWNER)
(573) 636-7382
Entity
Organization
Contact information
Practice address
4810 RAINBOW DR., JEFFERSON CITY, MO 65109
(573) 636-7382
(573) 636-3262
Mailing address
4810 RAINBOW DR, JEFFERSON CITY, MO 65109-6202
(573) 636-7382
(573) 636-3262
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
CERTIFIED PED 0825
MO
332BC3200X
Customized Equipment (DME)
0825
MO
335E00000X
Prosthetic/Orthotic Supplier
Primary
0825
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
626086201
—
MO
Enumeration date
11/23/2007
Last updated
12/12/2016
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