Organization
AROOSTOOK ORTHOTICS AND PROSTHETICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DONNA L GALLANT BOCO CPED CMF (OWNER)
(207) 762-3808
Entity
Organization
Contact information
Practice address
40 NORTH STREET SUITE 6, PRESQUE ISLE, ME 04769
(207) 762-3808
(207) 762-3809
Mailing address
40 NORTH STREET SUITE 6, PO BOX 269, PRESQUE ISLE, ME 04769
(207) 762-3808
(207) 762-3809
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
1049058
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
040533
BLUE CROSS BLUE SHIELD
ME
05
—
1332800000
—
ME
01
—
7529122
AETNA
—
Enumeration date
03/01/2006
Last updated
08/22/2020
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