Organization
PROPEL ORTHO LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. THOR L MATAYA CPOA (MANAGING PARTNER)
(267) 980-7415
Entity
Organization
Contact information
Practice address
3033 WINKLER AVE, FORT MYERS, FL 33916-9413
(267) 980-7415
(215) 638-2119
Mailing address
3033 WINKLER AVE, FORT MYERS, FL 33916-9413
(267) 980-7415
(215) 638-2119
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
04/08/2016
Last updated
04/08/2016
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