NPI 1114174182

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Organisation Prosthetic/Orthotic Supplier Queen Creek, AZ

Practice location

Address: 3154 E Bagdad Rd, Queen Creek, AZ 85243-4526
Phone: (480) 584-4785
Fax: (480) 584-4785
Mailing address: PO Box 2036, Higley, AZ 85236-2036

Authorised official

Name: Od'Esser Feen Weber
Title: Owner/Sales
Phone: (480) 584-4785

Registered specialties

Prosthetic/Orthotic Supplier Primary

Suppliers Taxonomy 335E00000X

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Registry record

NPI: 1114174182
Entity type: Organization
NPI issued: 21 Aug 2008
Record last updated: 21 Aug 2008

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.