Healthcare Provider Details

I. General information

NPI: 1679528046
Provider Name (Legal Business Name): ORTHOPEDIC CARE SPECIALISTS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/24/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 ROCHE BROS. WAY
EASTON MA
02356
US

IV. Provider business mailing address

PO BOX 30
STOUGHTON MA
02072-0030
US

V. Phone/Fax

Practice location:
  • Phone: 781-344-3535
  • Fax: 781-341-2404
Mailing address:
  • Phone: 781-341-4871
  • Fax: 781-341-2404

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. SUZANNE MARVIN
Title or Position: CEO
Credential:
Phone: 781-573-1666