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General NPI Number Information
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NPI Number | 1275536484
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Entity Type | Organization
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Legal Business Name | ALLIANCE ORTHOPEDIC LABS, LLC
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Dates
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Enumeration Date | 05/23/2005
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Last Update Date | 01/21/2019
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Provider Practice Location Address
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Address Line | 134 HOLIDAY CT STE 302
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City | ANNAPOLIS
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State | MD
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Zip | 21401
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Country | US
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Telephone | 410-224-2000
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Fax | 410-224-5696
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Provider Business Mailing Address
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Address Line | 17530 DUGDALE DR
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City | SOUTH BEND
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State | IN
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Zip | 46635-1583
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Country | US
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Telephone | 574-233-3352
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Fax | 574-288-1514
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Authorized Official
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Title or Position | CFO
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Name | JEFFREY LADERER
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Credential |
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Telephone | 574-233-3352
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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 | 02991470
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License Number State | MD
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Taxonomy #2
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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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