Organization
JEFFREY L BOUSE
Active
Other names
HAYES SHOE STORE
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JEFFREY L BOUSE (OWNER)
(573) 885-7312
Entity
Organization
Contact information
Practice address
103 S SMITH ST, CUBA, MO 65453-1235
(573) 885-7312
(573) 885-7312
Mailing address
103 S SMITH ST, CUBA, MO 65453-1235
(573) 885-7312
(573) 885-7312
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
08/29/2009
Last updated
11/20/2012
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