Organization
CANTON ORTHOTIC LABORATORY INC
Active
Organization
CANTON ORTHOTIC LABORATORY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STEPHEN THOMAS SIMKO I (PRESIDENT/LICENSED ORTHOTIST)
(330) 833-0955
Entity
Organization
Contact information
Practice address
2400 WALES AVE NW, SUITE H, MASSILLON, OH 44646-0804
(330) 833-0955
(330) 833-0980
Mailing address
2400 WALES AVE NW, SUITE H, MASSILLON, OH 44646-0804
(330) 833-0955
(330) 833-0980
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
—
—
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000155415
ANTHEM COMMUNITY MUTUAL
OH
05
—
0291143
—
OH
Enumeration date
04/06/2006
Last updated
09/11/2025
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