| NPI | 1770778961 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES MATTERN President 954-917-5655 |
| Organization Subpart ? | No |
| Primary Taxonomy | 222Z00000X Orthotist (Licence: FL ORT112) |
| Additional Taxonomies | 224P00000X Prosthetist (Licence: FL POR65) |
| Enumeration Date | 2007-09-11 |
| Last Update Date | 2010-05-14 |