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Organization

FOOTPRINT ORTHOTICS LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. JON MITCHELL (COOWNER)
(570) 372-0707
Entity
Organization

Contact information

Practice address
2 ATRIUM CT, SUITE B, SELINSGROVE, PA 17870-9019
(570) 372-0707
(570) 372-0799
Mailing address
2 ATRIUM CT, SUITE B, SELINSGROVE, PA 17870-9019

Taxonomy

Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
6000008656
PA

Other

Enumeration date
07/14/2015
Last updated
07/24/2015
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