NPI 1952634982

Quad City Prosthetic INC

Organisation Prosthetic/Orthotic Supplier Peru, IL

Practice location

Address: 1222 Shooting Park Rd #104, Peru, IL 61354
Phone: (815) 223-1781
Fax: (815) 223-1787
Mailing address: 741 W Main St, Peoria, IL 61606-1953

Authorised official

Name: Donald Goertzen
Title: President
Phone: (309) 676-2276

Registered specialties

Prosthetic/Orthotic Supplier Primary

Suppliers Taxonomy 335E00000X

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Registry record

NPI: 1952634982
Entity type: Organization
NPI issued: 9 Sep 2009
Record last updated: 30 Jul 2018

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.