Organization
SCIOTO SHOE MART INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHANNON LEE STARK CERTIFIED PEDORTHIST (MANAGER/ C.PED)
(740) 389-5775
Entity
Organization
Contact information
Practice address
206 JAMES WAY, MARION, OH 43302-5818
(740) 389-5775
(740) 389-1269
Mailing address
206 JAMES WAY, MARION, OH 43302-5818
(740) 389-5775
(740) 389-1269
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
—
—
Other
Enumeration date
07/22/2008
Last updated
07/29/2009
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