Organization
SMART FEET LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN CLARK LAWRENCE (CPED)
(502) 437-0134
Entity
Organization
Contact information
Practice address
77 MACK WALTERS RD STE 301B, SHELBYVILLE, KY 40065-1793
(502) 437-0134
(502) 437-0086
Mailing address
77 MACK WALTERS RD STE 301B, SHELBYVILLE, KY 40065-1793
(502) 437-0134
Taxonomy
Speciality
Code
Description
License number
State
224L00000X
Pedorthist
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1103830568
ANTHEM BLUE CROSS BLUE SHIELD
KY
01
—
286446
HME & SERVICES PROVIDER
KY
05
—
7100871590
—
KY
Enumeration date
02/23/2022
Last updated
11/01/2024
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