Provider Demographics
NPI:1730853714
Name:ORTHOTIC WORKS
Entity type:Organization
Organization Name:ORTHOTIC WORKS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JANET
Authorized Official - Middle Name:L
Authorized Official - Last Name:MAHONEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:978-491-8084
Mailing Address - Street 1:16623 W ROAD RIVER
Mailing Address - Street 2:
Mailing Address - City:INGLIS
Mailing Address - State:FL
Mailing Address - Zip Code:34449-4804
Mailing Address - Country:US
Mailing Address - Phone:978-491-8084
Mailing Address - Fax:
Practice Address - Street 1:16623 W ROAD RIVER
Practice Address - Street 2:
Practice Address - City:INGLIS
Practice Address - State:FL
Practice Address - Zip Code:34449-3444
Practice Address - Country:US
Practice Address - Phone:978-491-8084
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ARETE REHABILITATION, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-08-04
Last Update Date:2023-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment