Organization
NORTHEAST SHOE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS ASHLEY MARIE TIERNEY (OWNER)
(570) 465-2135
Entity
Organization
Contact information
Practice address
INTERSECTION RR 11 & RT 706, RR 3 BOX 22C, NEW MILFORD, PA 18834-9708
(570) 465-2135
(570) 465-5400
Mailing address
INTERSECTION RR 11 & RT 706, RR 3 BOX 22C, NEW MILFORD, PA 18834-9708
(570) 465-2135
(570) 465-5400
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
12/21/2007
Last updated
06/03/2008
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