COUNTRY COBBLER LTD. NPI 1255681797

NPI Information

COUNTRY COBBLER, LTD. is a prosthetic orthotic supplier in Durham, NC. The provider is an organization that provides prosthetic and orthotic care which may include, but is not limited to, patient evaluation, prosthesis or orthosis design, fabrication, fitting and modification to treat limb loss for purposes of restoring physiological function and/or cosmesis or to treat a neuromusculoskeletal disorder or acquired condition. COUNTRY COBBLER, LTD. NPI is 1255681797. The provider is registered as an organization entity type.

The provider's business location address is:

6815 FAYETTEVILLE ROAD
#102
DURHAM, NC
ZIP 27713-081
Phone: (919) 248-0850
Fax: (919) 248-0935

The provider's authorized official is Monty K. Mantey .
The authorized official title is President/ownder and has the following contact phone number (910) 772-9994.

The enumeration date for this NPI number is 9/12/2012 and was last updated on 5/27/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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