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General NPI Number Information
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NPI Number | 1386506954
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Entity Type | Organization
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Legal Business Name | RENEWED MOBILITY PROSTHETICS AND MARTHA ELIZABETH MATTHEWS SOLE MBR
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Dates
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Enumeration Date | 12/02/2025
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Last Update Date | 12/02/2025
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Provider Practice Location Address
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Address Line | 1816 N BRIDGE ST
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City | ELKIN
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State | NC
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Zip | 28621-2104
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Country | US
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Telephone | 704-448-9000
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Fax |
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Provider Business Mailing Address
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Address Line | 816 SOUTHWEST DR
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City | DAVIDSON
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State | NC
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Zip | 28036-8922
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Country | US
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Telephone | 704-448-9000
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Fax |
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Authorized Official
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Title or Position | OWNER/PRACTITION
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Name | MARTHA ELIZABETH MATTTHEWS
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Credential | CPO
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Telephone | 704-448-9000
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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 |
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License Number State |
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