# CUSTOM ORTHOTIC SOLUTIONS, INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1144609009
- **Authorized official:** MELANIE RITA CARLONE PT (OWNER/PROVIDER)
- **Authorized official phone:** (541) 790-2092

## Contact information

- **Practice address:** 784 NANTUCKET AVE, EUGENE, OR 97404
- **Practice address phone:** (541) 790-2092
- **Practice address fax:** (541) 636-5352
- **Mailing address:** 784 NANTUCKET AVE, EUGENE, OR 97404-2719
- **Mailing address phone:** (541) 790-2092
- **Mailing address fax:** (541) 636-5352

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QP2000X | Physical Therapy Clinic/Center | 06505 | OR | Yes |

## Other

- **Enumeration date:** 05/26/2015
- **Last updated:** 05/17/2018