Provider Demographics
NPI:1861144271
Name:KC SHOE STOP, LLC
Entity type:Organization
Organization Name:KC SHOE STOP, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NATASHA
Authorized Official - Middle Name:COLLETTE
Authorized Official - Last Name:BELCHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:913-486-1190
Mailing Address - Street 1:10820 W 64TH ST STE 200
Mailing Address - Street 2:
Mailing Address - City:SHAWNEE
Mailing Address - State:KS
Mailing Address - Zip Code:66203-3571
Mailing Address - Country:US
Mailing Address - Phone:913-486-1190
Mailing Address - Fax:913-300-9624
Practice Address - Street 1:10820 W 64TH ST STE 200
Practice Address - Street 2:
Practice Address - City:SHAWNEE
Practice Address - State:KS
Practice Address - Zip Code:66203-3571
Practice Address - Country:US
Practice Address - Phone:913-486-1190
Practice Address - Fax:913-300-9624
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-26
Last Update Date:2022-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225000000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotic FitterGroup - Single Specialty