Organization
FIDELITY ORTHOPEDIC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK MURKA (VICE PRESIDENT)
(937) 228-0682
Entity
Organization
Contact information
Practice address
8514 N MAIN ST, DAYTON, OH 45415-1325
(937) 228-0682
Mailing address
8514 N MAIN ST, DAYTON, OH 45415-1325
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2307417
—
OH
05
—
2728347
—
OH
Enumeration date
11/04/2015
Last updated
11/04/2015
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