Provider Demographics
NPI:1386506954
Name:RENEWED MOBILITY PROSTHETICS AND MARTHA ELIZABETH MATTHEWS SOLE MBR
Entity type:Organization
Organization Name:RENEWED MOBILITY PROSTHETICS AND MARTHA ELIZABETH MATTHEWS SOLE MBR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRACTITION
Authorized Official - Prefix:
Authorized Official - First Name:MARTHA
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:MATTTHEWS
Authorized Official - Suffix:
Authorized Official - Credentials:CPO
Authorized Official - Phone:704-448-9000
Mailing Address - Street 1:816 SOUTHWEST DR
Mailing Address - Street 2:
Mailing Address - City:DAVIDSON
Mailing Address - State:NC
Mailing Address - Zip Code:28036-8922
Mailing Address - Country:US
Mailing Address - Phone:704-448-9000
Mailing Address - Fax:
Practice Address - Street 1:1816 N BRIDGE ST
Practice Address - Street 2:
Practice Address - City:ELKIN
Practice Address - State:NC
Practice Address - Zip Code:28621-2104
Practice Address - Country:US
Practice Address - Phone:704-448-9000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-12-02
Last Update Date:2025-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier