# NUTMEG ORTHOTICS AND PROSTHETICS LLC

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

## Provider details

- **NPI number:** 1831578913
- **Authorized official:** JENNIFER L MANOUSE (MEMBER)
- **Authorized official phone:** (860) 355-2443

## Contact information

- **Practice address:** 85 BARNES RD, SUITE 302, WALLINGFORD, CT 06492-1832
- **Practice address phone:** (203) 678-4627
- **Practice address fax:** (203) 678-4628
- **Mailing address:** 73 ASPETUCK AVE, NEW MILFORD, CT 06776-2825
- **Mailing address phone:** (860) 355-2443

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 335E00000X | Prosthetic/Orthotic Supplier | CPO2372 | CT | Yes |

## Other

- **Enumeration date:** 05/22/2015
- **Last updated:** 05/22/2015