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General NPI Number Information
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NPI Number | 1407834369
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Entity Type | Organization
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Legal Business Name | ORTHOTIC & PROSTHETIC SPECIALTIES, INC.
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Dates
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Enumeration Date | 01/02/2006
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Last Update Date | 06/29/2016
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Provider Practice Location Address
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Address Line | 20650 LAKELAND BLVD
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City | EUCLID
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State | OH
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Zip | 44119-3241
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Country | US
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Telephone | 216-531-2773
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Fax | 216-531-5376
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Provider Business Mailing Address
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Address Line | 20650 LAKELAND BLVD
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City | EUCLID
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State | OH
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Zip | 44119-3241
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Country | US
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Telephone | 216-531-2773
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Fax | 216-531-5376
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. RICHARD D GAUDIO
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Credential |
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Telephone | 216-531-2773
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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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