NPI | 1649664251 |
---|---|
Entity Type | Organization |
Authorized Contact | MICHAEL PONO MCDOWELL Vice President/Co Owner 321-877-4732 |
Organization Subpart ? | No |
Primary Taxonomy | 224P00000X Prosthetist (Licence: FL POR 134) |
Additional Taxonomies | 222Z00000X Orthotist (Licence: FL POR 134) |
Enumeration Date | 2015-03-20 |
Last Update Date | 2021-09-17 |