Organization
MT MEDICAL, LLC
Active
Other names
Comfort Footwear Etc
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ILYA TSVOK C-PED (PRESIDENT)
(860) 232-1868
Entity
Organization
Contact information
Practice address
208 PARK RD, WEST HARTFORD, CT 06119-2015
(860) 232-1868
(860) 761-2658
Mailing address
208 PARK RD, WEST HARTFORD, CT 06119-2015
(860) 232-1868
(860) 761-2658
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004214269
—
CT
Enumeration date
07/13/2006
Last updated
07/20/2020
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