Organization · Type 2 NPI
The Custom Source Inc
Prosthetic/Orthotic Supplier · Matthews, NC
Practice location
1013 Chestnut Ln Ste 120
Matthews, NC 28104-8567
Fax (704) 973-0696
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Orthotist | 222Z00000X | None listed |
| Durable Medical Equipment & Medical Supplies | 332B00000X | None listed |
| Prosthetic/Orthotic Supplier Primary | 335E00000X | None listed |
Prosthetic/Orthotic Supplier: An organization that provides prosthetic and orthotic care which may include, but is not limited to, patient evaluation, prosthesis or orthosis design, fabrication, fitting and modification to treat limb loss for purposes of restoring physiological function and/or cosmesis or to treat a neuromusculoskeletal disorder or acquired condition.
Another provider at this address
Other prosthetic/orthotic supplier providers in Matthews
- Laced By Shea Inc.Prosthetic/Orthotic Supplier Matthews, NC NPI 1033783501
- Prosthetic Orthotic Care Center,incProsthetic/Orthotic Supplier Matthews, NC NPI 1275616211
- Hanger Prosthetics & Orthotics East IncProsthetic/Orthotic Supplier Matthews, NC NPI 1699053272
- Nagenneh StylesProsthetic/Orthotic Supplier Matthews, NC NPI 1952992687
About NPI 1114902665
The Custom Source Inc's National Provider Identifier is 1114902665, issued on Dec 7, 2005. The primary taxonomy on file is Prosthetic/Orthotic Supplier (335E00000X), and the practice location is in Matthews, NC. The record was last updated on Jul 21, 2022.