Organization
J.U.S.T. ORTHOTICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD SURFACE (PRESIDENT)
57360550321
Entity
Organization
Contact information
Practice address
106 PERRY PLZ, PERRYVILLE, MO 63775-1207
(573) 605-0321
Mailing address
106 PERRY PLAZA, PERRYVILLE, MO 63775
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LC001493885
STATE OF MISSOURI
MO
Enumeration date
08/29/2016
Last updated
08/29/2016
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