# MOBILE ORTHOTIC & PROSTHETIC SERVICES

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

## Provider details

- **NPI number:** 1497090641
- **Authorized official:** MR. GRADY G LEWIN BOCP., CFO (MEMBER)
- **Authorized official phone:** (914) 720-3321

## Contact information

- **Practice address:** 429 SALEM ST, BRIDGEPORT, CT 06606-4684
- **Practice address phone:** (914) 720-3321
- **Mailing address:** 429 SALEM ST, BRIDGEPORT, CT 06606-4684
- **Mailing address phone:** (914) 720-3321

## Taxonomy

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

## Other

- **Enumeration date:** 11/28/2012
- **Last updated:** 11/28/2012