Organization
PEDIATRIC ORTHOTIC AND PROSTHETIC SERVICES- NORTHEAST, LLC
Active
Parent organization
PEDIATRIC ORTHOTIC AND PROSTHETIC SERVICES- NORTHEAST, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
PEDIATRIC ORTHOTIC AND PROSTHETIC SERVICES- NORTHEAST, LLC
Authorized official
MS. CALLI CLARK CPO (DIRECTOR OF ORTHOTICS & PROSTHETICS)
(215) 430-4096
Entity
Organization
Contact information
Practice address
3551 N BROAD ST, PHILADELPHIA, PA 19140
(215) 430-4000
(215) 430-4027
Mailing address
PO BOX 947109, ATLANTA, GA 30394-7109
(813) 367-2876
(813) 518-7659
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
PA
Other
Enumeration date
01/05/2015
Last updated
04/23/2025
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