NPI 1023503497

Evergreen Prosthetics and Orthotics, LLC

Organisation Prosthetic/Orthotic Supplier Caldwell, ID

Practice location

Address: 1818 S 10th Ave STE 240, Caldwell, ID 83605-4880
Phone: (208) 608-6014
Mailing address: 911 Main St STE 100, Oregon City, OR 97045-1853

Authorised official

Name: Timothy L O'Neill
Title: Owner
Phone: (503) 407-5408

Registered specialties (2)

Prosthetic/Orthotic Supplier Primary

Suppliers Taxonomy 335E00000X

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Durable Medical Equipment & Medical Supplies

Suppliers Taxonomy 332B00000X

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Registry record

NPI: 1023503497
Entity type: Organization
NPI issued: 27 Jun 2018
Record last updated: 30 Oct 2023

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.