Organization
CARL'S FOOTWEAR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOEL BOUSEMA (PRESIDENT)
(712) 324-2623
Entity
Organization
Contact information
Practice address
319 9TH ST, SHELDON, IA 51201-1556
(712) 324-2623
Mailing address
319 9TH ST, SHELDON, IA 51201-1556
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
71006602
IA
Other
Enumeration date
01/08/2007
Last updated
11/19/2007
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