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General NPI Number Information
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NPI Number | 1073580759
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Entity Type | Organization
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Legal Business Name | ADVANCED ORTHOTICS & PROSTHETICS , LLC
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Dates
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Enumeration Date | 03/02/2006
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Last Update Date | 08/04/2008
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Provider Practice Location Address
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Address Line | 950 HOOSICK RD
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City | TROY
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State | NY
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Zip | 12180-6635
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Country | US
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Telephone | 518-279-4422
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Fax | 518-279-0033
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Provider Business Mailing Address
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Address Line | 950 HOOSICK RD
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City | TROY
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State | NY
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Zip | 12180-6635
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Country | US
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Telephone | 518-279-4422
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Fax | 518-279-0033
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Authorized Official
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Title or Position | CO-OWNER
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Name | MR. MICHAEL V BOLTON
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Credential | CO
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Telephone | 518-279-4422
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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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