SOLE SOURCE LLC YOUR DIABETIC SHOE STORE
NPI 1063778884
Prosthetic/Orthotic Supplier in Ypsilanti, MI

Q: What is Sole Source LLC Your Diabetic Shoe Store's specialty?

The primary specialty registered for this NPI is Prosthetic/Orthotic Supplier with taxonomy code 335E00000X.

Active since April 05, 2012

50 N HURON ST, YPSILANTI, MI 48197(734) 340-9614(734) 879-2774 Get Directions Write a Review

NPPES record last updated: May 22, 2012. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Sole Source Llc Your Diabetic Shoe Store NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SOLE SOURCE LLC YOUR DIABETIC SHOE STORE (NPI 1063778884) is a healthcare organization registered as a prosthetic/orthotic supplier in Ypsilanti, Michigan and active in the NPI registry since April 2012. The organization lists Annette Bottum, Shoe Fitter, as its authorized official.

NPPES Registry Identity

NPI1063778884

Entity TypeOrganization

Primary Taxonomy335E00000X

Legal Business NameSOLE SOURCE LLC YOUR DIABETIC SHOE STORE

Location Address50 N HURON STYpsilanti, MI 48197-2608

Mailing Address50 N Huron StYpsilanti, MI 48197-2608 · (734) 340-9614 · Fax (734) 879-2774

Phone(734) 340-9614

Fax(734) 879-2774

Organization SubpartNo

Authorized OfficialAnnette BottumShoe Fitter · (734) 340-9614

Enumeration DateApril 5, 2012

Last NPPES UpdateMay 22, 2012

✔ NPI 1063778884 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyProsthetic/Orthotic SupplierSuppliers

Taxonomy Code335E00000X

Definition

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.

50 N HURON ST, Ypsilanti, MI 48197

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Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ANNETTE B BOTTUM

Orthotic Fitter

50 N HURON ST
YPSILANTI, MI 48197

Washtenaw County (734) 340-6914

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Sole Source LLC Your Diabetic Shoe Store's NPI number?

The NPI number for Sole Source LLC Your Diabetic Shoe Store is 1063778884. It was assigned to this organization in the NPPES registry on April 5, 2012.

Where is Sole Source LLC Your Diabetic Shoe Store located?

Sole Source LLC Your Diabetic Shoe Store is located at 50 N Huron St, Ypsilanti, MI 48197. The listed phone number is (734) 340-9614.

What is Sole Source LLC Your Diabetic Shoe Store's specialty?

The primary specialty registered for this NPI is Prosthetic/Orthotic Supplier with taxonomy code 335E00000X.

When was this NPI record last updated?

The NPPES record for Sole Source LLC Your Diabetic Shoe Store was last updated on May 22, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.