Organization
QUALITY COBBLER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LARRY J MILLER OST (PRESIDENT)
(563) 263-9372
Entity
Organization
Contact information
Practice address
1903 PARK AVE, MUSCATINE MALL, MUSCATINE, IA 52761-5400
(563) 263-9372
Mailing address
1903 PARK AVE, MUSCATINE MALL, MUSCATINE, IA 52761-5400
(563) 263-9372
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0433763
—
IA
Enumeration date
07/07/2006
Last updated
08/22/2020
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