Organization
WISE FOOTWEAR, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KIRK R WISE LPO (OWNER)
(419) 236-1367
Entity
Organization
Contact information
Practice address
1008 BELLEFONTAINE AVE, LIMA, OH 45804
(419) 236-1367
Mailing address
PO BOX 569, LIMA, OH 45802-0569
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
OH
Other
Enumeration date
07/26/2007
Last updated
07/26/2007
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