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General NPI Number Information
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NPI Number | 1134127061
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Entity Type | Organization
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Legal Business Name | UNITED PROSTHETICS, INC
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Dates
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Enumeration Date | 07/13/2005
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Last Update Date | 03/12/2019
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Provider Practice Location Address
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Address Line | 295 COLUMBIA RD
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City | DORCHESTER
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State | MA
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Zip | 02121-3409
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Country | US
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Telephone | 617-436-6110
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Fax | 617-436-2424
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Provider Business Mailing Address
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Address Line | 295 COLUMBIA RD
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City | DORCHESTER
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State | MA
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Zip | 02121-3409
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Country | US
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Telephone | 617-436-6110
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Fax | 617-436-2424
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Authorized Official
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Title or Position | BOOKKEEPER/OWNER
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Name | MS. MARY A MARTINO
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Credential |
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Telephone | 617-436-6110
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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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