Organization
ORTHOTIC CENTER, INC.
Active
Other names
OrthoConcepts
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KEN GREENE C.O. (PRESIDENT)
(440) 528-8222
Entity
Organization
Contact information
Practice address
31100 SOLON RD, SOLON, OH 44139-2843
(440) 528-8222
(440) 528-8228
Mailing address
31100 SOLON RD, PO BOX 39415, SOLON, OH 44139-3462
(440) 528-8222
(440) 528-8228
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000155524
ANTHEM BCBS
OH
05
—
004229979
—
CT
05
—
0480500
—
OH
05
—
4434706
—
MI
Enumeration date
02/08/2006
Last updated
04/04/2011
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