Individual provider · Type 1 NPI
Gene Casamera Reavis Iii, CO
Prosthetic/Orthotic Supplier · Phila, PA
Practice location
901 S 55th St Unit A2
Phila, PA 19143-4005
Mailing address
901 S 55th St
Philadelphia, PA 19143-4005
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Prosthetic/Orthotic Supplier Primary | 335E00000X | CO264177 (PA) |
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.
About NPI 1659150696
Gene Casamera Reavis Iii, CO's National Provider Identifier is 1659150696, issued on Sep 28, 2023. The primary taxonomy on file is Prosthetic/Orthotic Supplier (335E00000X), and the practice location is in Phila, PA. The record was last updated on Sep 28, 2023.