Dynamics Orthotics And Prosthetics LLC
Durable Medical Equipment & Medical Supplies in Mableton, GA. Organization (NPI-2).
NPI number1790801041
StatusActive
Last updated in NPPESAug 16, 2010
Details
- NPI
- 1790801041
- Entity type
- Organization (NPI-2)
- Legal business name
- Dynamics Orthotics And Prosthetics LLC
- Organization subpart
- No
- Enumeration date
- Mar 21, 2007
- Last updated
- Aug 16, 2010
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 332B00000X | Durable Medical Equipment & Medical Supplies | 2007#120651 | GA | Yes |
Practice location
5701 Mableton Pkwy Sw Ste 102Mableton, GA 30126-3395
Phone 678-398-8710 · Fax 678-398-8711
Mailing address
4599 Somerset Rd SwSmyrna, GA 30082-4538
Phone 770-953-4877 · Fax 770-988-8958
Authorized official
M Maxwell Fitzgerald
Ceo
7709534877
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