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MARY FREE BED ORTHOTICS AND PROSTHETICS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ROBERT TUCK CPO (DIRECTOR OF COMPLIANCE)
(616) 502-6488
Entity
Organization

Contact information

Practice address
430 E LASALLE AVE, SOUTH BEND, IN 46617-2724
(616) 840-8007
Mailing address
235 WEALTHY ST SE STE 1100, GRAND RAPIDS, MI 49503-5247
(616) 840-8007

Taxonomy

Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary

Other

Enumeration date
10/04/2024
Last updated
11/13/2025
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