Organization
JACKRABBIT SHOES AND ORTHOTICS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DALE SOVAK (OWNER)
(707) 751-1630
Entity
Organization
Contact information
Practice address
4576 E 2ND ST, H, BENICIA, CA 94510-1046
(707) 751-1630
(925) 226-3184
Mailing address
4576 E 2ND ST, H, BENICIA, CA 94510-1046
(707) 751-1630
(925) 226-3184
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
CPED 2916
CA
Other
Enumeration date
03/18/2011
Last updated
03/18/2011
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