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General NPI Number Information
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NPI Number | 1114143567
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Entity Type | Organization
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Legal Business Name | ARIZONA PROSTHETIC ORTHOTICS SERVICES
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Dates
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Enumeration Date | 04/17/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2933 N CAMPBELL AVE
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City | TUCSON
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State | AZ
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Zip | 85719-2801
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Country | US
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Telephone | 520-229-0622
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Fax |
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Provider Business Mailing Address
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Address Line | 15855 N GREENWAY HAYDEN LOOP STE 140
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City | SCOTTSDALE
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State | AZ
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Zip | 85260-1660
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | COO
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Name | MR. ROGER GOETTL
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Credential |
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Telephone | 520-229-0622
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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 | 07-668261-R
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License Number State | AZ
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