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General NPI Number Information
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NPI Number | 1689679995
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Entity Type | Organization
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Legal Business Name | ORTHOTIC PROSTHETIC SPECIALISTS, INC.
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Dates
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Enumeration Date | 06/15/2005
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Last Update Date | 06/04/2013
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Provider Practice Location Address
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Address Line | 625 RIDGE RD STE D
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City | MUNSTER
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State | IN
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Zip | 46321-1695
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Country | US
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Telephone | 219-836-8668
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Fax | 219-836-8778
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Provider Business Mailing Address
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Address Line | 625 RIDGE RD STE D
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City | MUNSTER
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State | IN
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Zip | 46321-1695
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Country | US
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Telephone | 219-836-8668
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Fax | 219-836-8778
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. JOSEPH C. ROOKER
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Credential | CPO
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Telephone | 219-836-8668
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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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