Organization
NISSI CORPORATION
Active
Other names
The Good Feet Store
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LAWRENCE EDWARD BUCKMAN III CERT. PEDORTHIST (PRESIDENT)
(847) 658-8500
Entity
Organization
Contact information
Practice address
782 S RANDALL RD, ALGONQUIN, IL 60102-5915
(847) 658-8500
(847) 658-8858
Mailing address
782 S RANDALL RD, ALGONQUIN, IL 60102-5915
(847) 658-8500
(847) 658-8858
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
07/30/2008
Last updated
07/30/2008
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