# PROSTHETIC SPECIALTIES LLC

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

## Provider details

- **NPI number:** 1326483264
- **Authorized official:** BRET DOUGLAS RECKINGER (PRESIDENT)
- **Authorized official phone:** (763) 607-3372

## Contact information

- **Practice address:** 13143 LAKE PLACE RD, ZIMMERMAN, MN 55398-9567
- **Practice address phone:** (763) 607-3372
- **Mailing address:** 13143 LAKE PLACE RD, ZIMMERMAN, MN 55398-9567
- **Mailing address phone:** (763) 607-3372

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 335E00000X | Prosthetic/Orthotic Supplier | — | NULL | Yes |

## Other

- **Enumeration date:** 05/06/2013
- **Last updated:** 05/06/2013