Organization
V&A BOOTERY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ELLIOTT ROSS MILLER (MANAGER)
(630) 880-9528
Entity
Organization
Contact information
Practice address
6292 S WESTNEDGE AVE, PORTAGE, MI 49002-2810
(269) 323-9888
(269) 323-7907
Mailing address
6292 S WESTNEDGE AVE, PORTAGE, MI 49002-2810
(269) 323-9888
(269) 323-7907
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
07/05/2019
Last updated
07/05/2019
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