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General NPI Number Information
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NPI Number | 1417007154
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Entity Type | Organization
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Legal Business Name | ORTHOTIC CONCEPTS INC
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Dates
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Enumeration Date | 01/12/2007
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Last Update Date | 07/01/2010
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Provider Practice Location Address
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Address Line | 320 LIBBEY INDUSTRIAL PKWY SUITE 3A
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City | WEYMOUTH
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State | MA
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Zip | 02189-3107
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Country | US
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Telephone | 781-340-0444
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Fax | 781-340-0486
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Provider Business Mailing Address
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Address Line | 320 LIBBEY INDUSTRIAL PKWY SUITE 3A
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City | WEYMOUTH
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State | MA
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Zip | 02189-3107
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Country | US
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Telephone | 781-340-0444
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Fax | 781-340-0486
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. WARREN WILLIAM PATTEN
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Credential | CO, BOCO
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Telephone | 781-340-0444
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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 | MA
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