Organization
ORTHOTIC & PROSTHETIC SPECIALTIES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHRISTOPHER BERDAHL CP (PRESIDENT)
(605) 334-2311
Entity
Organization
Contact information
Practice address
2910 E 26TH ST, SIOUX FALLS, SD 57103-4034
(605) 334-2311
(605) 334-7748
Mailing address
2910 E 26TH ST, SIOUX FALLS, SD 57103-4034
(605) 334-2311
(605) 334-7748
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0544775
—
IA
01
—
4997360
BLUE CROSS BLUE SHIELD
SD
05
—
8769338-00
—
MN
05
—
9150580
—
SD
Enumeration date
05/12/2006
Last updated
11/03/2020
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