Organization
ADVANCE PROSTHETICS AND ORTHOTICS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL DEAN RICHARD C.P.O. (PRESIDENT)
(904) 858-1515
Entity
Organization
Contact information
Practice address
4537 EMERSON ST, JACKSONVILLE, FL 32207-4918
(904) 858-1515
Mailing address
4537 EMERSON ST, JACKSONVILLE, FL 32207-4918
(904) 858-1515
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
POR67
FL
Other
Enumeration date
03/02/2006
Last updated
07/01/2021
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