Organization
PARK SHOES INC.
Active
Other names
Village Bootery
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TERESA ANN O'BRIEN (SALES/BILLING)
(772) 283-3833
Entity
Organization
Contact information
Practice address
2641 SE OCEAN BLVD, STUART, FL 34996-3401
(772) 746-3536
(772) 744-7851
Mailing address
2641 SE OCEAN BLVD, STUART, FL 34996-3401
(772) 746-3536
(772) 744-7851
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
5114170001
FL
Other
Enumeration date
05/14/2008
Last updated
05/14/2008
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