Organization
NORTHERN ORTHOPEDIC LABORATORY INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DONALD W HOLMES CPO (PRESIDENT)
(315) 782-9079
Entity
Organization
Contact information
Practice address
6604 STATE HIGHWAY 56 APT 6, POTSDAM, NY 13676-3546
(315) 782-9079
Mailing address
1012 WASHINGTON ST, WATERTOWN, NY 13601-4337
(315) 782-9079
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
10/24/2019
Last updated
10/24/2019
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