Organization
STYLE SHOP
Active
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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