Organization
SUPERIOR SPORTS MEDICINE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GREGORY C FEDERICO ORTHOTIC FITTER (MANAGER)
(919) 459-4135
Entity
Organization
Contact information
Practice address
175 TOWERVIEW COURT, CARY, NC 27513
(919) 459-4135
(919) 882-1247
Mailing address
PO BOX 880, CARY, NC 27512-0880
(919) 459-4135
(919) 882-1247
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
000878433
NC
335E00000X
Prosthetic/Orthotic Supplier
00811
NC
Other
Enumeration date
09/27/2005
Last updated
04/16/2009
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