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Organization
ORTHOTIC LAB
Active
Organization
ORTHOTIC LAB
Active
Parent organization
DR KEVIN D RHODES
Organization subpart
Yes
Provider details
NPI number
Legal business name
DR KEVIN D RHODES
Authorized official
DR. KEVIN RHODES DPM (OWNER)
(817) 332-5500
Entity
Organization
Contact information
Practice address
800 8TH AVE STE 536, FORT WORTH, TX 76104-2604
(817) 332-5500
(817) 332-5503
Mailing address
800 8TH AVE STE 536, FORT WORTH, TX 76104-2604
(817) 332-5500
(817) 332-5503
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103849906
—
TX
Enumeration date
08/02/2018
Last updated
08/02/2018
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