Organization
SHOE FITTERS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. HENRY ALBERT BETETA (OWNER)
(303) 423-6712
Entity
Organization
Contact information
Practice address
7220 W 38TH AVE, WHEAT RIDGE, CO 80033-4841
(303) 423-6712
(303) 423-7206
Mailing address
7220 W 38TH AVE, WHEAT RIDGE, CO 80033-4841
(303) 423-6712
(303) 423-7206
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08002743
—
CO
01
—
7001-3
PROVIDER NUMBER
CO
01
—
8200146
PROVIDER NUMBER
CO
Enumeration date
06/25/2006
Last updated
08/22/2020
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