MEDICARE: WISCONSIN ORTHOTICS & PROSTHETICS CENTER LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	335E00000X	Prosthetic/Orthotic Supplier
2	332B00000X	Durable Medical Equipment & Medical Supplies
3	332BC3200X	Customized Equipment (DME)

General Provider Information

NPI Number	:	1114566395
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WISCONSIN ORTHOTICS & PROSTHETICS CENTER LLC

Provider Business Mailing Address
First Line	:	7071 S 13TH ST STE 102
Second Line	:
City	:	OAK CREEK
State	:	WI
Zip	:	53154-1466
Country	:	US
Telephone Number	:	414-246-2151
Fax Number	:

Provider Business Practice Location Address
First Line	:	7071 S 13TH ST STE 102
Second Line	:
City	:	OAK CREEK
State	:	WI
Zip	:	53154-1466
Country	:	US
Telephone Number	:	414-246-2151
Fax Number	:	414-246-2224

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ABDUL WALEED
Credential	:
Telephone Number	:	414-246-2151

Provider Enumeration Date	:	01/05/2020
Last Update Date	:	01/21/2026

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