Organization
SPECTRUM PROSTHETICS AND ORTHOTICS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. FOREST RAY SEXTON CPO (PRESIDENT)
(541) 955-9678
Entity
Organization
Contact information
Practice address
300 UNION AVE, SUITE C, GRANTS PASS, OR 97527-5861
(541) 955-9678
(541) 471-4909
Mailing address
300 UNION AVE, SUITE C, GRANTS PASS, OR 97527-5861
(541) 955-9678
(541) 471-4909
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
158752
—
OR
Enumeration date
11/06/2006
Last updated
07/14/2009
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