COUNTRY COBBLER LTD. NPI 1780646653

NPI Information

COUNTRY COBBLER, LTD. is a prosthetic orthotic supplier in Wilmington, 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 1780646653. The provider is registered as an organization entity type.

The provider's business location address is:

3501 OLEANDER DR
SUITE 11
WILMINGTON, NC
ZIP 28403-824
Phone: (910) 772-9994
Fax: (910) 772-1262

The provider's authorized official is Mark Allen Mantey .
The authorized official title is Diabetic Shoe Program Facilitator and has the following contact phone number (910) 772-9994.

The enumeration date for this NPI number is 4/5/2006 and was last updated on 9/18/2015.

Taxonomy Codes

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Other Identifiers

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