Organization
SPRINGFIELD ORTHOPAEDIC & PEDORTHIC SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HUNTER TULLY (CEO)
(954) 621-6887
Entity
Organization
Contact information
Practice address
2100 S BRENTWOOD BLVD STE A, SPRINGFIELD, MO 65804-2534
(417) 888-0887
Mailing address
2100 S BRENTWOOD BLVD STE A, SPRINGFIELD, MO 65804-2534
(417) 888-0887
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
626363402
—
MO
Enumeration date
02/25/2008
Last updated
10/17/2024
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