| NPI | 1295730216 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARCUM R RANDALL President PT Cp Lpo 239-437-4010 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier |
| Additional Taxonomies | 261QP2000X Clinic/Center, Physical Therapy |
| Enumeration Date | 2005-06-16 |
| Last Update Date | 2012-08-30 |