MEDICARE: ORTHOMED LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1346681285
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ORTHOMED LLC

Provider Business Mailing Address
First Line	:	PO BOX 64207
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85728-4207
Country	:	US
Telephone Number	:	480-706-1161
Fax Number	:	480-706-7997

Provider Business Practice Location Address
First Line	:	7530 N ORACLE RD
Second Line	:	SUITE 100
City	:	TUCSON
State	:	AZ
Zip	:	85704-4450
Country	:	US
Telephone Number	:	520-202-2030
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	JOHN WOOLF
Credential	:
Telephone Number	:	520-321-0204

Provider Enumeration Date	:	07/08/2013
Last Update Date	:	11/16/2016

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Directions to “ORTHOMED LLC ” Practice Location

Language	Start Address	Practice Location

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