Organization
ORTHOTIC & PROSTHETIC LAB INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CYNTHIA KAYE ALLEN (OFFICE MANAGER)
(812) 479-6298
Entity
Organization
Contact information
Practice address
125 N WEINBACH AVE, SUITE 310, EVANSVILLE, IN 47711-6091
(812) 479-6298
(812) 479-6758
Mailing address
125 N WEINBACH AVE, SUITE 310, EVANSVILLE, IN 47711-6091
(812) 479-6298
(812) 479-6758
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100179970A
—
IN
Enumeration date
01/08/2007
Last updated
02/04/2010
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