| NPI | 1306043625 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREW D DOMB Owner 561-296-2000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 224P00000X Prosthetist (Licence: FL POR188) |
| Additional Taxonomies | 222Z00000X (Licence: FL POR188) |
| Enumeration Date | 2007-06-29 |
| Last Update Date | 2010-08-02 |