Organization
ONTARIO PROSTHETICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BENJAMIN PHILLIPS CP (OWNER)
(951) 247-4140
Entity
Organization
Contact information
Practice address
12981 PERRIS BLVD STE 101, MORENO VALLEY, CA 92553-4108
(951) 247-4140
(951) 247-4563
Mailing address
12981 PERRIS BLVD STE 101, MORENO VALLEY, CA 92553-4108
(951) 247-4140
(951) 247-4563
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
P 1115
CA
Other
Enumeration date
09/20/2006
Last updated
08/22/2020
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