Organization
OTTO BOCK ORTHOPEDIC SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY LEWIS (EVP OF LICENSURE)
(512) 806-2756
Entity
Organization
Contact information
Practice address
70 GLEN ST STE 230, GLEN COVE, NY 11542-2854
(516) 200-5111
Mailing address
PO BOX 734949, DALLAS, TX 75373-4949
(800) 736-8276
(866) 642-2302
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
332BC3200X
Customized Equipment (DME)
—
—
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
04/02/2019
Last updated
10/22/2025
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