Organization
VANDYGRIFF SHOES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. IRWIN R VANLDYGRIFF (OWNER)
(501) 745-4060
Entity
Organization
Contact information
Practice address
179 WOODELL ST, CLINTON, AR 72031-6929
(501) 745-4060
(501) 745-4012
Mailing address
179 WOODELL ST, CLINTON, AR 72031-6929
(501) 745-4060
(501) 745-4012
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
12/19/2007
Last updated
04/20/2008
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