MEDICARE: ORTHOTIC & PROSTHETIC SPECIALISTS, INC.

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

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1437339710
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ORTHOTIC & PROSTHETIC SPECIALISTS, INC.

Provider Business Mailing Address
First Line	:	101 HIGHLAND PARK PLZ
Second Line	:
City	:	COVINGTON
State	:	LA
Zip	:	70433-7128
Country	:	US
Telephone Number	:	985-898-6319
Fax Number	:

Provider Business Practice Location Address
First Line	:	101 HIGHLAND PARK PLZ
Second Line	:
City	:	COVINGTON
State	:	LA
Zip	:	70433-7128
Country	:	US
Telephone Number	:	985-898-6319
Fax Number	:	985-867-8803

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MICHAEL STEPHEN RELLE
Credential	:	CPO
Telephone Number	:	985-898-6319

Provider Enumeration Date	:	11/05/2007
Last Update Date	:	04/09/2020

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