Organization
ORTHODYNAMX LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THEODORE P BLACKMAN (OWNER)
(407) 961-1449
Entity
Organization
Contact information
Practice address
2735 W STATE ROAD 434 UNIT 1021, LONGWOOD, FL 32779-4483
(407) 637-5957
Mailing address
2735 W STATE ROAD 434 UNIT 1021, LONGWOOD, FL 32779-4483
(407) 637-5957
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
10/24/2022
Last updated
10/24/2022
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