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Organization

ORTHOTIC AND PROSTHETIC LAB, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. DAVID J OSTERMAN (OWNER)
(314) 968-8555
Entity
Organization

Contact information

Practice address
6 EMERALD TER, SUITE 1, SWANSEA, IL 62226-2312
(618) 235-4864
Mailing address
748 MARSHALL AVE, WEBSTER GROVES, MO 63119-1924
(314) 968-8555

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
335E00000X
Prosthetic/Orthotic Supplier
211.000024
IL
335E00000X
Prosthetic/Orthotic Supplier
Primary
213.000099
IL

Other

Enumeration date
12/12/2006
Last updated
02/16/2017
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