Organization
BARTS SHOE CORP
Active
Other names
Jays Wide Shoes
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ALAN BARTHOLD C-PED (OWNER)
(503) 641-5199
Entity
Organization
Contact information
Practice address
4037 SW 117TH AVE, SUITE J, BEAVERTON, OR 97005-8900
(503) 627-0113
(503) 574-2813
Mailing address
4037 SW 117TH AVE, SUITE J, BEAVERTON, OR 97005-8900
(503) 627-0113
(503) 574-2813
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
05/02/2008
Last updated
05/15/2008
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