Organization
INTERCOASTAL ORTHOTICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM NOVACK (OWNER)
(407) 367-9149
Entity
Organization
Contact information
Practice address
885 SE 6TH AVE STE E, DELRAY BEACH, FL 33483-5184
(561) 332-3295
Mailing address
851 SE 6TH AVE STE E, DELRAY BEACH, FL 33483-5276
(561) 332-3295
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
12/17/2018
Last updated
12/27/2018
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