Organization
CERTIFIED PROSTHETICS & ORTHOTICS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CASEY JOSEPH BRADSHAW (PARTNER/OWNER)
(308) 635-3700
Entity
Organization
Contact information
Practice address
2621 5TH AVE, SCOTTSBLUFF, NE 69361-1745
(308) 635-3700
(308) 635-3709
Mailing address
2621 5TH AVE, SCOTTSBLUFF, NE 69361-1745
(308) 635-3700
(308) 635-3709
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
10561404
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10025756000
—
NE
Enumeration date
07/23/2013
Last updated
07/23/2013
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