Md Orthotic And Prosthetic Laboratory, Inc in Peoria - Prosthetic/orthotic Supplier
Md Orthotic And Prosthetic Laboratory, Inc - NPI 1881746758
Md Orthotic And Prosthetic Laboratory, Inc is a Prosthetic/orthotic Supplier in Peoria, Illinois. Md Orthotic And Prosthetic Laboratory, Inc practices all healthcare services and medical treatments related to Prosthetic/orthotic Supplier. The NPI Number for Md Orthotic And Prosthetic Laboratory, Inc is 1881746758. The last update date is 2020-08-05.
Md Orthotic And Prosthetic Laboratory, Inc's current location address is 741 W Main St, Peoria, Illinois. You can contact this provider via phone number 8003345705 and fax number 8886636322. The mailing address for Md Orthotic And Prosthetic Laboratory, Inc is 741 W Main St, Peoria, Illinois. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Md Orthotic And Prosthetic Laboratory, Inc |
|---|---|
| Address | 741 W Main St, Peoria, Illinois |
| Phone Number | 8003345705 |
| Fax Number | 8886636322 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | PRESIDENT |
|---|---|
| Authorized Official Name | Goertzen Donald |
| Credentials | CPO |
| Telephone Number | 3096762276 |
NPI Number Detail
| NPI Number | 1881746758 |
|---|---|
| Provider Enumeration Date | 2007-01-18 |
| Last Updated Date | 2020-08-05 |
Provider Mailing Address Detail
| Address | 741 W Main St |
|---|---|
| City | Peoria |
| State | Illinois (IL) |
| Post Code | 616061953 |
| Phone Number | 8003345705 |
| Fax Number | 8886636322 |
Provider's Primary Taxonomy Detail
| Speciality | Prosthetic/orthotic Supplier |
|---|---|
| Taxonomy | 335E00000X |
| Licence No | 600086432130 |
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Definition: 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 f |
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What is the unique 10-digit identifier code assigned to Md Orthotic And Prosthetic Laboratory, Inc by the Centers for Medicare & Medicaid Services?
The Md Orthotic And Prosthetic Laboratory, Inc has been issued the NPI (National Provider Identifier) 1881746758 by the CMS (Centers for Medicare & Medicaid Services), which serves as a unique identification number for healthcare providers.
Where is the Md Orthotic And Prosthetic Laboratory, Inc located?
The Md Orthotic And Prosthetic Laboratory, Inc is located at 741 W Main St, Peoria, IL 616061953.
What is Md Orthotic And Prosthetic Laboratory, Inc's area of expertise and its corresponding taxonomy classification?
The Md Orthotic And Prosthetic Laboratory, Inc's field of specialization is Prosthetic/orthotic Supplier, and it falls under the taxonomy code 335E00000X, which categorizes healthcare providers based on their areas of practice.
On what date did the Centers for Medicare & Medicaid Services assign the 1881746758 to Md Orthotic And Prosthetic Laboratory, Inc?
The Centers for Medicare & Medicaid Services assigned the 1881746758 to Md Orthotic And Prosthetic Laboratory, Inc on 2007-01-18.
When was the information regarding Md Orthotic And Prosthetic Laboratory, Inc most recently updated?
The details pertaining to the Md Orthotic And Prosthetic Laboratory, Inc, including its address, specialty, and other relevant information, were last refreshed on 2020-08-05.