| NPI | 1306082722 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CLEMENT BUCKLEY NEWBOLD Certified Practioner/Owner 863-293-5444 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier (Licence: FL PRO108) |
| Enumeration Date | 2009-01-07 |
| Last Update Date | 2011-07-08 |