Organization
MANATEE PROSTHETICS & ORTHOTICS
Active
Other names
BRADENTON PROSTHETICS & ORTHOTICS
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN D HAGMAN LPO,CP (OWNER)
(941) 747-5407
Entity
Organization
Contact information
Practice address
535 8TH ST W, BRADENTON, FL 34205-8530
(941) 747-5407
(941) 747-4914
Mailing address
535 8TH ST W, BRADENTON, FL 34205-8530
(941) 747-5407
(941) 747-4914
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
POR131
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
026426100
—
FL
01
—
M2380
BC
FL
Enumeration date
02/13/2007
Last updated
12/15/2016
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