Provider Demographics
NPI:1245477413
Name:TOTAL MOBILITY AND MODIFICATION SERVICES
Entity type:Organization
Organization Name:TOTAL MOBILITY AND MODIFICATION SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CORPORATE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:Z
Authorized Official - Last Name:CRAFT
Authorized Official - Suffix:
Authorized Official - Credentials:ATP,CAPS
Authorized Official - Phone:407-574-6429
Mailing Address - Street 1:719 PROGRESS WAY
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:FL
Mailing Address - Zip Code:32771-6987
Mailing Address - Country:US
Mailing Address - Phone:407-574-6429
Mailing Address - Fax:407-330-6426
Practice Address - Street 1:719 PROGRESS WAY
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:FL
Practice Address - Zip Code:32771-6987
Practice Address - Country:US
Practice Address - Phone:407-574-6429
Practice Address - Fax:407-330-6426
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-09
Last Update Date:2009-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1313379332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment