# NORTH METRO ORTHOTICS AND PROSTHETICS, INC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** NORTH METRO ORTHOTICS AND PROSTHETICS, INC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1356589113
- **Legal business name:** NORTH METRO ORTHOTICS AND PROSTHETICS, INC
- **Authorized official:** JESSICA DEHAVEN (CORPORATE SECRETARY)
- **Authorized official phone:** (763) 784-6647

## Contact information

- **Practice address:** 3111 124TH AVE NW, SUITE 210, COON RAPIDS, MN 55433-4572
- **Practice address phone:** (763) 323-6921
- **Practice address fax:** (763) 323-6940
- **Mailing address:** 8290 UNIVERSITY AVE NE, SUITE 310, FRIDLEY, MN 55432-1847
- **Mailing address phone:** (763) 784-6647
- **Mailing address fax:** (763) 784-7747

## Taxonomy

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

## Other

- **Enumeration date:** 01/30/2009
- **Last updated:** 01/28/2014