Organization
AMERICAN ORTHOPEDIC & PROSTHETICS INC.
Active
Other names
Evergreen Prosthetics and Orthotics, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN MARTIN CREIGHTON BOCPO CTPO (PRESIDENT)
(765) 447-0111
Entity
Organization
Contact information
Practice address
720 FARABEE CT, LAFAYETTE, IN 47905-5917
(765) 447-0111
Mailing address
720 FARABEE CT, LAFAYETTE, IN 47905-5917
(765) 447-0111
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000097257
BLUE CROSS BLUE SHIELD
IN
05
—
100175540
—
IN
Enumeration date
07/13/2005
Last updated
03/17/2025
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