Organization
MEDSOURCE ORTHOTICS & PROSTHETICS, INC
Active
Other names
Hamilton Prosthetics
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID CHARLES (PRESIDENT)
(801) 890-6824
Entity
Organization
Contact information
Practice address
13203 N 103RD AVE STE J1&J2, SUN CITY, AZ 85351
(602) 395-3354
(602) 395-3361
Mailing address
3636 NORTH 3RD AVENUE, SUITE 100, PHOENIX, AZ 85013-3904
(602) 395-3354
(602) 395-3361
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
09/30/2016
Last updated
09/14/2018
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