Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Customized Equipment |
332BC3200X | 87 | All Other Suppliers |
| NPI Number | 1790949899 |
| LBN Legal business name | RE NU SHOE REPAIR INC |
| Authorized official | ANN BELLANTONI - (OWNER) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | 07/17/2008 |
| Last updated | 07/17/2008 - About 18 years ago |
| Identifiers | n/a |
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