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Organization

ADVANCED CUSTOM ORTHOTICS, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. DONALD B HAVEY (PRESIDENT)
(636) 536-2514
Entity
Organization

Contact information

Practice address
17600 CHESTERFIELD AIRPORT RD, STE B5, CHESTERFIELD, MO 63005-1246
(636) 536-2514
Mailing address
17600 CHESTERFIELD AIRPORT RD, STE B5, CHESTERFIELD, MO 63005-1246
(636) 536-2514

Taxonomy

Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary

Other

Enumeration date
04/28/2009
Last updated
11/23/2010
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