Organization
DIABETIC SHOE CLINIC LLC
Active
Other names
Diabetic Shoe Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
SHANNON KISER (OWNER)
(606) 644-3815
Entity
Organization
Contact information
Practice address
2611 GREENBO BLVD, FLATWOODS, KY 41139-1830
(606) 644-3815
Mailing address
652 SPRING MEADOW DR, RADCLIFF, KY 40160-9443
(606) 644-3815
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
332BC3200X
Customized Equipment (DME)
—
—
Other
Enumeration date
05/22/2025
Last updated
05/22/2025
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