NPI 1740113422
Form Orthotics & Prosthetics, PLLC
Practice location
- Address
- 4921 E State St Lowr Level, Rockford, IL 61108-2275
- Phone
- (402) 212-7878
Authorised official
- Name
- Micah Alford
- Title
- Founder
- Phone
- (402) 212-7878
Registered specialties
Prosthetic/Orthotic Supplier
Primary
Registry record
- NPI
- 1740113422
- Entity type
- Organization
- NPI issued
- 4 Jun 2026
- Record last updated
- 4 Jun 2026
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.