Intercoastal Orthotics & Prosthetics, LLC

NPI #1083839062 in Edgewater, Florida

Provider Information

NPI Number
1083839062
Entity Type
Organization
Organization Name
Intercoastal Orthotics & Prosthetics, LLC
Primary Specialty
Prosthetic/Orthotic Supplier
Enumeration Date
Apr 16, 2007
Last Updated
Aug 3, 2009

Practice Location

Address
1 PELICAN DR STE A
State
Florida
ZIP Code
32141-4254
Phone
(386) 409-9432

Authorized Official

Name
MR. TOM HARVEY MOWERY, CPO,LPO
Title
PROSTHETIST, ORTHOTIST
Phone
(386) 409-9432

Specialties & Taxonomy Codes

Specialty
Prosthetic/Orthotic Supplier

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