NPI 1619508702

Evergreen Prosthetics and Orthotics, LLC

Organisation Prosthetic/Orthotic Supplier Meridian, ID

Practice location

Address: 1500 E Heritage Park St STE 100, Meridian, ID 83646-5884
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: 1619508702
Entity type: Organization
NPI issued: 28 Jan 2020
Record last updated: 22 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.