Organization
REICHERT PROSTHETICS & ORTHOTICS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GRACE ANGELINE (REG COMPLIANCE SPECIALIST III)
(714) 961-2102
Entity
Organization
Contact information
Practice address
5027 GREEN BAY RD STE 124, KENOSHA, WI 53144-1771
(262) 654-4300
(262) 654-4305
Mailing address
4155 E LA PALMA AVE STE B400, ANAHEIM, CA 92807-1857
(714) 961-2102
(737) 209-6653
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
03/02/2012
Last updated
04/10/2020
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