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General NPI Number Information
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NPI Number | 1003544677
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Entity Type | Organization
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Legal Business Name | CLINICAL PROSTHETICS & ORTHOTICS, LLC
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Dates
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Enumeration Date | 08/11/2022
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Last Update Date | 09/08/2022
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Provider Practice Location Address
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Address Line | 17 MAIN ST
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City | QUEENSBURY
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State | NY
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Zip | 12804-4007
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Country | US
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Telephone | 518-828-1698
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Fax | 518-380-2393
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Provider Business Mailing Address
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Address Line | 17 MAIN ST
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City | QUEENSBURY
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State | NY
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Zip | 12804-4007
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Country | US
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Telephone | 518-828-1698
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Fax | 518-380-2393
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Authorized Official
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Title or Position | BUSINESS ADMINISTRATIVE MANAGER
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Name | TERESA ANN SANDERCOX
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Credential |
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Telephone | 315-538-3033
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number |
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License Number State |
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