Organization
ROSENDAHL FOOT AND SHOE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DON SHIPPY (OWNER)
(208) 343-4242
Entity
Organization
Contact information
Practice address
125 S CURTIS RD, BOISE, ID 83705-1014
(208) 343-4242
(208) 343-6764
Mailing address
125 S CURTIS RD, BOISE, ID 83705-1014
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
—
—
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
806600000
—
ID
Enumeration date
09/09/2008
Last updated
09/09/2008
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