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General NPI Number Information
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NPI Number | 1952488470
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Entity Type | Organization
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Legal Business Name | PRO FIT PROSTHETICS AND ORTHOTICS LLC
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Dates
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Enumeration Date | 11/01/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 901 ROUTE 168 SUITE 410
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City | TURNERSVILLE
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State | NJ
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Zip | 08012
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Country | US
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Telephone | 856-374-8006
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Fax | 856-374-0169
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Provider Business Mailing Address
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Address Line | 901 ROUTE 168 SUITE 410
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City | TURNERSVILLE
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State | NJ
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Zip | 08012
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Country | US
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Telephone | 856-374-8006
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Fax | 856-374-0169
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Authorized Official
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Title or Position | OWNER
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Name | MR. THOMAS EDWARD DALSEY
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Credential | CPO FAAOP
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Telephone | 856-374-8006
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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 | 45PO00015100
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License Number State | NJ
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