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General NPI Number Information
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NPI Number | 1215951983
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Entity Type | Organization
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Legal Business Name | AMERICAN ORTHO-TECH LABORATORIES INC.
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Dates
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Enumeration Date | 07/27/2006
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Last Update Date | 05/04/2023
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Provider Practice Location Address
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Address Line | 1414 W GRANADA BLVD STE 3
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City | ORMOND BEACH
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State | FL
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Zip | 32174-8104
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Country | US
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Telephone | 386-258-0401
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Fax | 386-252-1013
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Provider Business Mailing Address
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Address Line | 1414 W GRANADA BLVD STE 3
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City | ORMOND BEACH
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State | FL
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Zip | 32174-8104
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Country | US
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Telephone | 386-258-0401
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Fax | 386-252-1013
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Authorized Official
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Title or Position | DIRECTOR, CONTRACTING
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Name | JANET WOODALL
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Credential |
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Telephone | 336-397-0993
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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 | POR142
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License Number State | FL
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