Organization
MEDSOURCE ORTHOTICS & PROSTHETICS, INC
Active
Other names
Hamilton Prosthetics
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID CHARLES (PRESIDENT)
(801) 255-5202
Entity
Organization
Contact information
Practice address
1450 S DOBSON RD STE B326, MESA, AZ 85202
(602) 395-3354
(888) 828-8290
Mailing address
3636 N 3RD AVE STE 100, PHOENIX, AZ 85013-3938
(602) 395-3358
(888) 828-8290
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
21067439
AZ
Other
Enumeration date
06/18/2018
Last updated
09/14/2018
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