Healthcare Provider Details

I. General information

NPI: 1255440335
Provider Name (Legal Business Name): ORTHOPEDIC SPECIALTIES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 09/02/2025
Certification Date: 12/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2467 S TELSHOR BLVD
LAS CRUCES NM
88011-5049
US

IV. Provider business mailing address

2467 S TELSHOR BLVD
LAS CRUCES NM
88011-5049
US

V. Phone/Fax

Practice location:
  • Phone: 575-522-5773
  • Fax:
Mailing address:
  • Phone: 575-522-5773
  • Fax:

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: SARAH ULSH
Title or Position: MANAGER/PRESIDENT
Credential:
Phone: 575-522-5773