Organization
METROPOLITAN ORTHOTIC LABORATORY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DEBBY KAY MERRITT (BUSINESS MANAGER)
(612) 341-3660
Entity
Organization
Contact information
Practice address
817 PORTLAND AVE, MINNEAPOLIS, MN 55404-1145
(612) 341-3660
(612) 341-3664
Mailing address
817 PORTLAND AVE, MINNEAPOLIS, MN 55404-1145
(612) 341-3660
(612) 341-3664
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
58243ME
BCBS MN
MN
05
—
848363900
—
MN
Enumeration date
09/13/2006
Last updated
11/16/2012
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