Provider Demographics
NPI:1225210446
Name:STREHL'S FAMILY SHOES & REPAIR
Entity Type:Organization
Organization Name:STREHL'S FAMILY SHOES & REPAIR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER - CERTIFIED PEDORTHIC
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARILYN
Authorized Official - Middle Name:A
Authorized Official - Last Name:STREHL
Authorized Official - Suffix:
Authorized Official - Credentials:CPED 2262
Authorized Official - Phone:707-725-2610
Mailing Address - Street 1:1155 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FORTUNA
Mailing Address - State:CA
Mailing Address - Zip Code:95540-2101
Mailing Address - Country:US
Mailing Address - Phone:707-725-0192
Mailing Address - Fax:
Practice Address - Street 1:1155 MAIN ST
Practice Address - Street 2:
Practice Address - City:FORTUNA
Practice Address - State:CA
Practice Address - Zip Code:95540-2101
Practice Address - Country:US
Practice Address - Phone:707-725-0192
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-29
Last Update Date:2007-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACPED. 2262332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies