| NPI | 1326138306 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JODI TIDWELL Pedorthist/CEO 954-346-5402 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: FL PED117) |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2020-08-22 |