Organization
ORTHOPEDIC SUPPLY INC
Active
Other names
philadelphia diabetic shoes
Organization subpart
No
Provider details
NPI number
Authorized official
AKSANA A PERAKROSTAVA (OWNER)
(215) 677-6194
Entity
Organization
Contact information
Practice address
9150 MARSHALL ST, SUITE 7, PHILADELPHIA, PA 19114-2217
(215) 677-6194
Mailing address
9150 MARSHALL ST, SUITE 7, PHILADELPHIA, PA 19114-2217
(215) 677-6194
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
09/05/2006
Last updated
09/29/2008
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