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General NPI Number Information
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NPI Number | 1235291378
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Entity Type | Organization
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Legal Business Name | BT ORTHOTIC LABS, INC.
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Dates
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Enumeration Date | 12/14/2006
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Last Update Date | 11/05/2019
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Provider Practice Location Address
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Address Line | 96 E MAIN ST UNIT 1
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City | HUNTINGTON
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State | NY
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Zip | 11743-2816
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Country | US
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Telephone | 631-470-3778
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Fax | 631-423-1550
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Provider Business Mailing Address
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Address Line | 96 E MAIN ST UNIT 1
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City | HUNTINGTON
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State | NY
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Zip | 11743-2816
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Country | US
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Telephone | 631-470-3778
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Fax | 631-423-1550
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Authorized Official
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Title or Position | VICE PRESIDENT / CO-OWNER
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Name | MS. KATHRYN ANNE BETHEL
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Credential |
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Telephone | 631-470-3778
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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