NPI 1578150454

Evergreen Prosthetics and Orthotics, LLC

Organisation Prosthetic/Orthotic Supplier Fruitland, ID

Practice location

Address: 425 S Whitley Dr STE 431, Fruitland, ID 83619-2611
Phone: (208) 884-1294
Fax: (208) 884-1293
Mailing address: 911 Main St STE 100, Oregon City, OR 97045-1853

Authorised official

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

Registered specialties

Prosthetic/Orthotic Supplier Primary

Suppliers Taxonomy 335E00000X

Other Prosthetic/Orthotic Supplier providers in Idaho →

Registry record

NPI: 1578150454
Entity type: Organization
NPI issued: 28 Dec 2020
Record last updated: 1 Nov 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.