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General NPI Number Information
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NPI Number | 1376900548
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Entity Type | Organization
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Legal Business Name | OREGON ORTHOTIC SERVICES, INC
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Dates
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Enumeration Date | 01/19/2016
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Last Update Date | 01/19/2016
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Provider Practice Location Address
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Address Line | 2030 BLUE MESA CT
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City | LOVELAND
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State | CO
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Zip | 80538-4188
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Country | US
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Telephone | 970-672-4937
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Fax | 970-672-2883
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Provider Business Mailing Address
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Address Line | 2030 BLUE MESA CT
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City | LOVELAND
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State | CO
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Zip | 80538-4188
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Country | US
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Telephone | 970-672-4937
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Fax | 970-672-2883
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Authorized Official
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Title or Position | LEAD OFFICE ADMINISTRATOR
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Name | MRS. KELLIE MAFFUCCI
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Credential |
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Telephone | 503-242-9136
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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 | 20166000095
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License Number State | CO
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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 | 20166000095
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License Number State | CO
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