MEDICARE: GARRISON'S ORTHOTHIC & PROSTHETIC

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	335E00000X	Prosthetic/Orthotic Supplier

General Provider Information

NPI Number	:	1790781482
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GARRISON'S ORTHOTHIC & PROSTHETIC

Provider Business Mailing Address
First Line	:	1531 E ATLANTIC BLVD
Second Line	:
City	:	POMPANO BEACH
State	:	FL
Zip	:	33060-6748
Country	:	US
Telephone Number	:	954-960-8747
Fax Number	:	305-949-5546

Provider Business Practice Location Address
First Line	:	1531 E ATLANTIC BLVD
Second Line	:
City	:	POMPANO BEACH
State	:	FL
Zip	:	33060-6748
Country	:	US
Telephone Number	:	954-960-8757
Fax Number	:	305-949-5546

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. KEVIN S. GARRISON
Credential	:	C.P., L.P.
Telephone Number	:	954-960-8747

Provider Enumeration Date	:	06/27/2005
Last Update Date	:	11/06/2009

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Directions to “GARRISON'S ORTHOTHIC & PROSTHETIC ” Practice Location

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