NPI 1376226910

MD Orthotic and Prosthetic Laboratory, INC

Organisation Prosthetic/Orthotic Supplier Naperville, IL

Practice location

Address: 387 Shuman Blvd STE 201e, Naperville, IL 60563-8306
Phone: (630) 283-1830
Fax: (630) 320-2282
Mailing address: 741 W Main St, Peoria, IL 61606-1953

Authorised official

Name: Kendra F Mickelson
Title: Manager of Revenue Cycle Management
Phone: (309) 285-7752

Registered specialties

Prosthetic/Orthotic Supplier Primary

Suppliers Taxonomy 335E00000X

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Registry record

NPI: 1376226910
Entity type: Organization
NPI issued: 10 Aug 2023
Record last updated: 24 Sep 2024

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.