Organization
STEVE'S SHOE SERVICE & PEDORTHIC CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STEVEN ALAN PETRARCA OST C PED (OWNER)
(401) 885-5004
Entity
Organization
Contact information
Practice address
135 FRENCHTOWN ROAD, SUITE 4, NORTH KINGSTOWN, RI 02852-1783
(401) 885-5004
(401) 885-8283
Mailing address
135 FRENCHTOWN ROAD, SUITE 4, NORTH KINGSTOWN, RI 02852-1783
(401) 885-5004
(401) 885-8283
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
29672
BLUE CROSS
—
01
—
408288
BLUE CHIP
—
Enumeration date
04/01/2008
Last updated
08/20/2008
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