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General NPI Number Information
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NPI Number | 1689914004
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Entity Type | Organization
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Legal Business Name | KIDDER ORTHOPEDIC LABORATORIES INC.
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Dates
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Enumeration Date | 02/21/2013
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Last Update Date | 02/21/2013
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Provider Practice Location Address
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Address Line | 301 S CITRUS AVE
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City | INVERNESS
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State | FL
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Zip | 34452-4705
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Country | US
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Telephone | 352-419-7969
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Fax | 352-419-7973
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Provider Business Mailing Address
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Address Line | 301 S CITRUS AVE
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City | INVERNESS
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State | FL
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Zip | 34452-4705
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Country | US
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Telephone | 352-419-7969
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Fax | 352-419-7973
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | JOHN E MESSER
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Credential | CPO, LPO
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Telephone | 352-419-7969
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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 | POR193
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License Number State | FL
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