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
59 MAIN ST, SUITE 300, POTSDAM, NY 13676-2148
(315) 265-1673
(315) 265-1675
Mailing address
59 MAIN ST, SUITE 300, POTSDAM, NY 13676-2148
(315) 265-1673
(315) 265-1675
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02073449
—
NY
Enumeration date
02/05/2007
Last updated
08/22/2020
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