Organization
TAYLORED SHOES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEITH TAYLOR (OWNER/C.PED)
(707) 290-0627
Entity
Organization
Contact information
Practice address
1035 SAN PABLO AVE, SUIT 8, ALBANY, CA 94706-2275
(707) 290-0627
Mailing address
2401 WATERMAN BLVD, SUIT 4A PMB 115, FAIRFIELD, CA 94534-1800
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
12/23/2011
Last updated
02/16/2012
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