Organization
MEDSOURCE ORTHOTICS & PROSTHETICS
Active
Parent organization
MEDSOURCE ORTHOTICS & PROSTHETICS
Other names
Hamilton Prosthetic Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
MEDSOURCE ORTHOTICS & PROSTHETICS
Authorized official
DAVID CHARLES (PRESIDENT)
(801) 255-5202
Entity
Organization
Contact information
Practice address
9305 W. THOMAS RD, SUITE 150, PHOENIX, AZ 85037
(623) 738-0301
(602) 395-3361
Mailing address
3636 N 3RD AVE STE 100, PHOENIX, AZ 85013-3938
(602) 395-3354
(602) 395-3361
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
11/14/2006
Last updated
05/15/2018
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