| NPI | 1710342290 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ARTHUR GAGNE Managing Member 352-701-0494 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA0900X Clinic/Center Amputee (Licence: FL POR 191) |
| Additional Taxonomies | 261QP2000X Clinic/Center Physical Therapy (Licence: FL OT 11205) |
| 261QR0400X Clinic/Center Rehabilitation (Licence: FL OT 11205) | |
| 335E00000X Prosthetic/Orthotic Supplier | |
| Enumeration Date | 2015-12-28 |
| Last Update Date | 2019-06-25 |