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1982102877
ONDREY TOBIAS ISAAC
STONE MOUNTAIN, GA
NPI
1982102877
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
335E00000X Prosthetic/Orthotic Supplier
(Licence: FL CL1259854)
Enumeration Date
2018-01-25
Last Update Date
2018-01-25
Business Address
ONDREY TOBIAS ISAAC
971 N HAIRSTON RD
STONE MOUNTAIN, GA 30083-2871
Phone number: 772-828-6370
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Mailing Address
ONDREY TOBIAS ISAAC
1908 AVENUE N
FORT PIERCE, FL 34950-2055
Phone number: 772-828-6370
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