Organization
MBR ORTHOTICS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL BRUCE REBARBER CO,LPO (PRES)
(201) 444-7750
Entity
Organization
Contact information
Practice address
579 GOFFLE RD, WYCKOFF, NJ 07481-2946
(201) 444-7750
Mailing address
579 GOFFLE RD, WYCKOFF, NJ 07481-2946
(201) 444-7750
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
45PO00005000
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3075907
—
NJ
Enumeration date
01/04/2006
Last updated
04/28/2008
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