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NPI 1508868878

NPI 1508868878 : PRECISION ORTHOTIC & PROSTHETIC TECHNOLOGY, INC. : NEW BEDFORD, MA

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General NPI Number Information
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    NPI Number           |    1508868878
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    Entity Type          |    Organization 
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    Legal Business Name  |    PRECISION ORTHOTIC & PROSTHETIC TECHNOLOGY, INC. 
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Dates
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    Enumeration Date     |    06/01/2005
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    Last Update Date     |    05/08/2008
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Provider Practice Location Address
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    Address Line         |    203 POPES ISLAND 
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    City                 |    NEW BEDFORD
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    State                |    MA
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    Zip                  |    02740-7232
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    Country              |    US
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    Telephone            |    508-991-5577
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    Fax                  |    508-991-5505
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Provider Business Mailing Address
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    Address Line         |    203 POPES ISLAND 
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    City                 |    NEW BEDFORD
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    State                |    MA
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    Zip                  |    02740-7232
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    Country              |    US
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    Telephone            |    508-991-5577
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    Fax                  |    508-991-5505
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Authorized Official
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    Title or Position    |    PRESIDENT
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    Name                 |    MR. MATTHEW E. HEBERT 
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    Credential           |    CP
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    Telephone            |    508-991-5577
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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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