Organization
TREASURE COAST PEDORTHICS INC
Active
Other names
Powell Shoes
Organization subpart
No
Provider details
NPI number
Authorized official
ALTHEA POWELL C.PED, L.PED (OWNER / OPERATOR)
(772) 562-9045
Entity
Organization
Contact information
Practice address
2686 US HIGHWAY 1, VERO BEACH, FL 32960-5080
(772) 562-9045
(772) 562-9436
Mailing address
2686 US HIGHWAY 1, VERO BEACH, FL 32960-5080
(772) 562-9045
(772) 562-9436
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
PED 78
FL
Other
Enumeration date
09/28/2007
Last updated
12/07/2015
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