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General NPI Number Information
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NPI Number | 1093993362
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Entity Type | Organization
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Legal Business Name | TAMPA ORTHOTIC MANAGEMENT SERVICES, INC
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Dates
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Enumeration Date | 02/08/2008
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Last Update Date | 02/03/2009
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Provider Practice Location Address
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Address Line | 5537 SHELDON RD SUITE N
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City | TAMPA
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State | FL
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Zip | 33615-3167
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Country | US
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Telephone | 813-886-9202
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Fax | 813-886-9223
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Provider Business Mailing Address
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Address Line | 5537 SHELDON RD SUITE N
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City | TAMPA
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State | FL
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Zip | 33615-3167
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Country | US
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Telephone | 813-886-9202
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Fax | 813-886-9223
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Authorized Official
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Title or Position | CERTIFIED ORTHOTIST/PRESIDENT
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Name | MR. THOMAS HURLEY ECKERSON
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Credential | CO, BOC, ABC
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Telephone | 813-886-9202
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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 | ORT19
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License Number State | FL
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