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General NPI Number Information
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NPI Number | 1972504124
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Entity Type | Organization
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Legal Business Name | COMPREHENSIVE PROSTHETIC SERVICES LLC
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Dates
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Enumeration Date | 08/09/2005
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Last Update Date | 05/07/2008
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Provider Practice Location Address
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Address Line | 21 BUSINESS PARK DR
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City | BRANFORD
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State | CT
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Zip | 06405-2935
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Country | US
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Telephone | 203-315-1400
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Fax | 203-315-1404
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Provider Business Mailing Address
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Address Line | 21 BUSINESS PARK DR
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City | BRANFORD
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State | CT
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Zip | 06405-2935
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Country | US
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Telephone | 203-315-1400
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Fax | 203-315-1404
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | MR. JOHN R ZENIE
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Credential | CPO, MBA
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Telephone | 203-315-1400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225000000X
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Taxonomy Name | Orthotic Fitter
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License Number | 3884152
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License Number State | CT
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