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General NPI Number Information
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NPI Number | 1023286762
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Entity Type | Organization
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Legal Business Name | MODERN REHABILITATION TECHNOLOGIES, LLC
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Dates
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Enumeration Date | 02/15/2008
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Last Update Date | 02/15/2008
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Provider Practice Location Address
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Address Line | 430 TONEY PENNA DR SUITE 6
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City | JUPITER
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State | FL
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Zip | 33458-5775
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Country | US
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Telephone | 561-748-5657
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Fax | 561-748-5658
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Provider Business Mailing Address
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Address Line | 329 MIDDLE COUNTRY RD SUITE 2
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City | SMITHTOWN
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State | NY
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Zip | 11787-2830
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Country | US
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Telephone | 631-360-6400
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Fax | 631-360-6449
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Authorized Official
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Title or Position | OWNER
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Name | WILLIAM M SCHWING
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Credential | CPO, LPO, BOCPO
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Telephone | 561-748-5657
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number | POR 170
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License Number State | FL
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