Organization
ACTIVE BRACE AND LIMB
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT SCOTT MOSHER (ORTHOTIST)
(231) 258-8481
Entity
Organization
Contact information
Practice address
215 S CEDAR STREET, KALKASKA, MI 49646
(231) 258-8481
Mailing address
5222 N ROYAL DR, TRAVERSE CITY, MI 49684-6883
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
03/28/2007
Last updated
08/22/2020
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