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Organization
MOBILE ORTHOTIC & PROSTHETIC SERVICES
Active
Organization
MOBILE ORTHOTIC & PROSTHETIC SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GRADY G LEWIN BOCP., CFO (MEMBER)
(914) 720-3321
Entity
Organization
Contact information
Practice address
429 SALEM ST, BRIDGEPORT, CT 06606-4684
(914) 720-3321
Mailing address
429 SALEM ST, BRIDGEPORT, CT 06606-4684
(914) 720-3321
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
NULL
Other
Enumeration date
11/28/2012
Last updated
11/28/2012
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