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General NPI Number Information
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NPI Number | 1376525998
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Entity Type | Organization
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Legal Business Name | ABC PROSTHETICS AND ORTHOTICS OF ALTAMONTE SPRINGS INC
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Dates
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Enumeration Date | 11/18/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 691 DOUGLAS AVE STE 103
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City | ALTAMONTE SPRINGS
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State | FL
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Zip | 32714-2571
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Country | US
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Telephone | 407-772-1990
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Fax | 407-772-1991
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Provider Business Mailing Address
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Address Line | 691 DOUGLAS AVE STE 103
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City | ALTAMONTE SPRINGS
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State | FL
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Zip | 32714-2571
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Country | US
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Telephone | 407-772-1990
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Fax | 407-772-1991
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Authorized Official
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Title or Position | BILLING MANAGER
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Name | WENDY A HARRIGAN
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Credential |
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Telephone | 407-341-5873
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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 | POR41
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License Number State | FL
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