Organization
ANIMATE PEDORTHICS ORTHOTICS & PROSTHETICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDGAR ALEXANDER BARRIOS PEDORTHIST (OWNER/CEO)
(312) 315-6584
Entity
Organization
Contact information
Practice address
307 W SAINT PAUL ST, SPRING VALLEY, IL 61362-1860
(312) 315-6584
Mailing address
5512 S WASHINGTON ST, HINSDALE, IL 60521-4914
(312) 315-6584
Taxonomy
Speciality
Code
Description
License number
State
222Z00000X
Orthotist
—
—
224L00000X
Pedorthist
—
—
225000000X
Orthotic Fitter
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
335E00000X
Prosthetic/Orthotic Supplier
—
—
Other
Enumeration date
04/14/2020
Last updated
04/16/2020
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