Healthcare Provider Details

I. General information

NPI: 1376527986
Provider Name (Legal Business Name): ORTHOTICS & PROSTHETICS REHABILITATION ENGINEERING CENTRE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/06/2005
Last Update Date: 08/15/2025
Certification Date: 06/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1695 NILES CORTLAND RD NE STE 1
WARREN OH
44484-1165
US

IV. Provider business mailing address

1695 NILES CORTLAND RD NE STE 1
WARREN OH
44484-1165
US

V. Phone/Fax

Practice location:
  • Phone: 330-856-2553
  • Fax: 330-856-4619
Mailing address:
  • Phone: 330-856-2553
  • Fax: 330-856-4619

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: MRS. DOROTHY J BILLOCK
Title or Position: VICE PRESIDENT
Credential:
Phone: 330-856-2553