Organization
DYNAMICS ORTHOTICS AND PROSTHETICS LLC
Active
Organization
DYNAMICS ORTHOTICS AND PROSTHETICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. M MAXWELL FITZGERALD (CEO)
(770) 953-4877
Entity
Organization
Contact information
Practice address
5701 MABLETON PKWY SW STE 102, MABLETON, GA 30126-3395
(678) 398-8710
(678) 398-8711
Mailing address
4599 SOMERSET RD SW, SMYRNA, GA 30082-4538
(770) 953-4877
(770) 988-8958
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
2007#120651
GA
Other
Enumeration date
03/21/2007
Last updated
08/16/2010
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