OrganizationActive
Country Cobbler, Ltd.
NPI 1780646653 · Prosthetic/Orthotic Supplier · Wilmington, NC
Provider details
- NPI number
- 1780646653
- Entity type
- Organization
- Primary specialty
- Prosthetic/Orthotic SupplierSuppliers
- Organization subpart
- No
- Authorized official
- Mark Mantey, Diabetic Shoe Program Facilitator(910) 772-9994
- License
- 00992 (NC)
Specialties & taxonomies
Suppliers
Practice location
3501 Oleander Dr
Suite 11
Wilmington, NC 28403-0824
Phone: (910) 772-9994
Fax: (910) 772-1262
Approximate (ZIP-level) locationGet directions
Mailing address
3501 Oleander Dr
Wilmington, NC 28403-0824
Registry dates
- Enumerated
- 2006-04-05
- Last updated
- 2015-09-18
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.