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General NPI Number Information
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NPI Number | 1275767147
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Entity Type | Organization
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Legal Business Name | ORTHOTICS & PROSTHETICS LABORATORIES, INC.
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Dates
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Enumeration Date | 05/07/2009
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Last Update Date | 04/04/2024
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Provider Practice Location Address
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Address Line | 3500 MAIN ST STE 101
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City | SPRINGFIELD
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State | MA
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Zip | 01107-1148
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Country | US
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Telephone | 413-737-2404
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Fax | 413-733-1389
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Provider Business Mailing Address
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Address Line | 300 BIRNIE AVE SUITE 303
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City | SPRINGFIELD
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State | MA
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Zip | 01107-1107
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Country | US
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Telephone | 413-737-2404
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Fax | 413-733-1389
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. JAMES HAAS
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Credential | C.O.
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Telephone | 413-737-2404
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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 | CO004133
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License Number State |
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