Organization
GEO ALLEN SHOES INC
Active
Other names
George Allen Shoes Inc
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DALLAS R POWERS C.PED (PRESIDENT)
(708) 388-8570
Entity
Organization
Contact information
Practice address
13003 WESTERN AVE, BLUE ISLAND, IL 60406-2406
(708) 388-8570
(708) 824-2606
Mailing address
13003 WESTERN AVE, BLUE ISLAND, IL 60406-2406
(708) 388-8570
(708) 824-2606
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
212-000021
IL
Other
Enumeration date
01/04/2007
Last updated
04/14/2020
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