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General NPI Number Information
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NPI Number | 1437338522
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Entity Type | Organization
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Legal Business Name | CONCORD PROSTHETICS AND ORTHOTICS
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Dates
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Enumeration Date | 10/25/2007
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Last Update Date | 12/17/2007
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Provider Practice Location Address
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Address Line | 801 MAIN ST SUITE 8
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City | CONCORD
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State | MA
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Zip | 01742-3313
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Country | US
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Telephone | 978-371-1684
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Fax | 978-371-7504
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Provider Business Mailing Address
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Address Line | 801 MAIN ST SUITE 8
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City | CONCORD
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State | MA
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Zip | 01742-3313
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Country | US
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Telephone | 978-371-1684
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Fax | 978-371-7504
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Authorized Official
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Title or Position | OWNER
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Name | NICHOLAS P GRIGORIEFF
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Credential |
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Telephone | 978-371-1684
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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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