Vagabond Shoes, INC.
Prosthetic/Orthotic Supplier in Green Bay, WI. Organization (NPI-2).
NPI number1356441950
StatusActive
Last updated in NPPESAug 22, 2020
Details
- NPI
- 1356441950
- Entity type
- Organization (NPI-2)
- Legal business name
- Vagabond Shoes, INC.
- Organization subpart
- No
- Enumeration date
- Sep 23, 2006
- Last updated
- Aug 22, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 335E00000X | Prosthetic/Orthotic Supplier | – | WI | Yes |
Practice location
635 Bay Park SqGreen Bay, WI 54304-5101
Phone 920-606-0163 · Fax 920-498-2429
Mailing address
635 Bay Park SqGreen Bay, WI 54304-5101
Phone 920-606-0163 · Fax 920-498-2429
Authorized official
Kathleen M Kelnhofer
Owner
9206060163
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