MEDICARE: NORTHERN ORTHOTICS & PROSTHETICS

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	335E00000X	Prosthetic/Orthotic Supplier

General Provider Information

NPI Number	:	1336548338
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NORTHERN ORTHOTICS & PROSTHETICS

Provider Business Mailing Address
First Line	:	1015 COMMERCE DR STE 102
Second Line	:
City	:	MARQUETTE
State	:	MI
Zip	:	49855-8694
Country	:	US
Telephone Number	:	906-273-2444
Fax Number	:

Provider Business Practice Location Address
First Line	:	2419 LUDINGTON ST
Second Line	:
City	:	ESCANABA
State	:	MI
Zip	:	49829-1328
Country	:	US
Telephone Number	:	906-553-7350
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	IVAN SABEL
Credential	:
Telephone Number	:	906-273-2444

Provider Enumeration Date	:	08/15/2014
Last Update Date	:	05/13/2026

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