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Organization

STYLE SHOP

Active
Other names
Mountain Insoles
Organization subpart
No

Provider details

NPI number
Authorized official
RUSSEL JOSEPH BOLLIG (PRESIDENT)
(303) 919-6917
Entity
Organization

Contact information

Practice address
555 TWINING FLATS RD, ASPEN, CO 81611-3119
(303) 919-6917
Mailing address
555 TWINING FLATS RD, ASPEN, CO 81611-3119
(303) 919-6917

Taxonomy

Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary

Other

Enumeration date
03/07/2017
Last updated
03/07/2017
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