Organization
PROSTHETIC DEVELOPMENT AND RESEARCH, INC.
Active
Organization
PROSTHETIC DEVELOPMENT AND RESEARCH, INC.
Active
Other names
San Juan Prosthetics and Orthotics, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TIMOTHY JOHN OBRIEN C.P.O. (PRESIDENT)
(970) 259-9258
Entity
Organization
Contact information
Practice address
1 MERCADO ST, STE. 203, DURANGO, CO 81301-7300
(970) 259-9258
(970) 385-7262
Mailing address
1 MERCADO ST, STE. 203, DURANGO, CO 81301-7300
(970) 259-9258
(970) 385-7262
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
1428
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08002149
—
CO
Enumeration date
07/09/2006
Last updated
08/22/2020
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