NPI 1437301074

Antonio Mario Sergio, REGSHOEMAKERMERCH

Practitioner Orthotist South Bend, IN

Practice location

Address: 1508 Mishawaka Avenue, South Bend, IN 46615-1426
Phone: (574) 246-9700

Registered specialties (2)

Orthotist Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 222Z00000X

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Orthotic Fitter

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225000000X

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Registry record

NPI: 1437301074
Entity type: Individual
Sex (as registered): Male
NPI issued: 15 Oct 2008
Record last updated: 15 Oct 2008

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.