NPI 1306803218

Creative Orthotic Laboratory

Organisation Prosthetic/Orthotic Supplier Glendale, AZ

Practice location

Address: 8608 N 59th Ave, Glendale, AZ 85302-5404
Phone: (623) 934-3213
Fax: (623) 930-1891

Authorised official

Name: Mark Richard Gorman
Title: C.E.O.
Phone: (623) 934-3213

Registered specialties

Prosthetic/Orthotic Supplier Primary

Suppliers Taxonomy 335E00000X

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Registry record

NPI: 1306803218
Entity type: Organization
NPI issued: 26 Apr 2006
Record last updated: 22 Aug 2020

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.