Organization
CERTIFIED ORTHOTIC & PROSTHETIC, INC
Active
Other names
CUSTOM DESIGN ORTHOTIC & PROSTHETIC
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STEVEN MARSHALL WILLIAMS LPO (PRESIDENT/PRACTITIONER)
(419) 756-6226
Entity
Organization
Contact information
Practice address
271 CLINE AVE, UNIT 3, MANSFIELD, OH 44907-1042
(419) 756-6226
(419) 756-7737
Mailing address
271 CLINE AVE, UNIT 3, MANSFIELD, OH 44907-1042
(419) 756-6226
(419) 756-7737
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
LPO144
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2307239
—
OH
Enumeration date
07/12/2005
Last updated
08/22/2020
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