Organization
POMAC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JON L SHRETER CPO (EXECUTIVE DIRECTOR)
(856) 273-9636
Entity
Organization
Contact information
Practice address
365 C NEW ALBANY RD., MOORESTOWN, NJ 08057
(856) 273-9636
(856) 273-7886
Mailing address
365 C NEW ALBANY ROAD, MOORESTOWN, NJ 08057
(856) 273-9636
(856) 273-7886
Taxonomy
Speciality
Code
Description
License number
State
225000000X
Orthotic Fitter
—
—
332BC3200X
Customized Equipment (DME)
Primary
—
—
Other
Enumeration date
09/11/2007
Last updated
02/27/2013
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