Organization
NORTHERN ORTHOPEDIC LABORATORY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DONALD W HOLMES CPO (PRESIDENT)
(315) 782-9079
Entity
Organization
Contact information
Practice address
500 STATE ST, OGDENSBURG, NY 13669-2632
(315) 393-4502
(315) 393-4653
Mailing address
500 STATE ST, OGDENSBURG, NY 13669-2632
(315) 393-4502
(315) 393-4653
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02063394
—
NY
Enumeration date
02/05/2007
Last updated
08/02/2013
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