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Organization

CUSTOM ORTHOPEDIC INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. CHERYL DEASE (PRESIDENT)
(941) 355-0337
Entity
Organization

Contact information

Practice address
1271 TALLEVAST RD, SARASOTA, FL 34243-3268
(941) 355-0337
(941) 355-0616
Mailing address
1271 TALLEVAST RD, SARASOTA, FL 34243-3268
(941) 355-0337
(941) 355-0616

Taxonomy

Speciality
Code
Description
License number
State
222Z00000X
Orthotist
Primary

Other

Enumeration date
01/29/2007
Last updated
06/18/2013
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