Organization
THE SHOE SMITH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN D WALKER C PED (OWNER)
(860) 423-8873
Entity
Organization
Contact information
Practice address
503 MAIN ST, WILLIMANTIC, CT 06226-3143
(860) 423-8873
(860) 456-0373
Mailing address
503 MAIN ST, WILLIMANTIC, CT 06226-3143
(860) 423-8873
(860) 456-0373
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004201381
—
CT
Enumeration date
03/18/2008
Last updated
05/16/2014
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