Jeffrey L Bouse

Organization Active NPI Prosthetic/Orthotic Supplier · Cuba, MO

NPI 1689807299 · NPPES record last updated Nov 20, 2012

Key facts

NPI
1689807299
Entity type
Organization (NPI type 2)
Primary specialty
Prosthetic/Orthotic Supplier 335E00000X
Legal business name
JEFFREY L BOUSE
Practice address
103 S Smith St
Cuba, MO 65453-1235
Phone
(573) 885-7312
Fax
(573) 885-7312
NPI assigned
Aug 29, 2009
Organization subpart
No

Authorized official

Name
Mr. Jeffrey L Bouse
Title
Owner
Phone
(573) 885-7312

National Provider Directory

Locations

103 S Smith St
Cuba, MO 65453
Phone (573) 885-7312

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthetic/Orthotic Supplier 335E00000X Yes

Addresses

Primary practice location

103 S Smith St
Cuba, MO 65453-1235

Mailing address

103 S Smith St
Cuba, MO 65453-1235
Phone (573) 885-7312

Other names

  • HAYES SHOE STORE Doing business as

Other providers in Cuba, MO

All providers in Cuba, MO · Prosthetic/Orthotic Supplier in Missouri

Sources for this page

Verify at the official NPI Registry.