Healthcare Provider Details

I. General information

NPI: 1033906979
Provider Name (Legal Business Name): COMFORT PROSTHETICS & ORTHOTICS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/23/2025
Last Update Date: 04/24/2025
Certification Date: 04/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2603 ELECTRIC AVE STE 4
PORT HURON MI
48060-6588
US

IV. Provider business mailing address

276 SOUTHBOUND GRATIOT AVE
MOUNT CLEMENS MI
48043-2475
US

V. Phone/Fax

Practice location:
  • Phone: 810-990-8285
  • Fax: 810-937-5068
Mailing address:
  • Phone: 586-468-4600
  • Fax: 586-468-9508

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VIII. Authorized Official

Name: ROBERT MANIERE
Title or Position: OWNER/PRESIDENT
Credential: CPO
Phone: 586-468-4600