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General NPI Number Information
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NPI Number | 1073886073
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Entity Type | Organization
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Legal Business Name | ORTHOPEDIC SERVICES LLC
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Dates
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Enumeration Date | 02/22/2012
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Last Update Date | 02/22/2012
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Provider Practice Location Address
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Address Line | 1175 MAINSAIL DR UNIT 702
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City | NAPLES
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State | FL
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Zip | 34114-8870
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Country | US
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Telephone | 207-446-0444
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Fax | 239-206-2487
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Provider Business Mailing Address
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Address Line | 1175 MAINSAIL DR UNIT 702
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City | NAPLES
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State | FL
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Zip | 34114-8870
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Country | US
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Telephone | 207-446-0444
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Fax | 239-206-2487
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Authorized Official
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Title or Position | OWNER
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Name | DR. JOHN J WALSH JR.
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Credential | MD
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Telephone | 207-446-0444
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | 010230
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License Number State | ME
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