Provider Demographics
NPI:1578787826
Name:GENUFEET, INC
Entity Type:Organization
Organization Name:GENUFEET, INC
Other - Org Name:FOOT SOLUTIONS OF MEQUON
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER - CERTIFIED PEDORTHIST
Authorized Official - Prefix:MR
Authorized Official - First Name:VERN
Authorized Official - Middle Name:D
Authorized Official - Last Name:WALTHER
Authorized Official - Suffix:
Authorized Official - Credentials:CPED
Authorized Official - Phone:262-241-3668
Mailing Address - Street 1:10918 N PORT WASHINGTON RD
Mailing Address - Street 2:
Mailing Address - City:MEQUON
Mailing Address - State:WI
Mailing Address - Zip Code:53092-5031
Mailing Address - Country:US
Mailing Address - Phone:262-241-3668
Mailing Address - Fax:262-241-3669
Practice Address - Street 1:10918 N PORT WASHINGTON RD
Practice Address - Street 2:
Practice Address - City:MEQUON
Practice Address - State:WI
Practice Address - Zip Code:53092-5031
Practice Address - Country:US
Practice Address - Phone:262-241-3668
Practice Address - Fax:262-241-3669
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-11
Last Update Date:2007-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier