Healthcare Provider Details
I. General information
NPI: 1609767672
Provider Name (Legal Business Name): OPEN BIONICS INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/09/2025
Last Update Date: 07/09/2025
Certification Date: 07/09/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
780 LYNNHAVEN PKWY STE 400
VIRGINIA BEACH VA
23452-7332
US
IV. Provider business mailing address
200 UNION BLVD STE 440
LAKEWOOD CO
80228-1812
US
V. Phone/Fax
- Phone: 877-437-6276
- Fax: 720-640-0405
- Phone: 720-417-8698
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 222Z00000X |
| Taxonomy | Orthotist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 224P00000X |
| Taxonomy | Prosthetist |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 335E00000X |
| Taxonomy | Prosthetic/Orthotic Supplier |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ELISE
GRISET
Title or Position: DIRECTOR OF CLINICAL OPERATIONS
Credential:
Phone: 720-417-8698