Organization
BI-STATE ORTHOTICS AND PROSTHETICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. THOMAS J NIEDER SR. COF (PRESIDENT)
(314) 843-2664
Entity
Organization
Contact information
Practice address
12660 LAMPLIGHTER SQR SHPPNG CTR, SUITE J, SAINT LOUIS, MO 63128-2761
(314) 843-2664
Mailing address
12660 LAMPLIGHTER SQR SHPPNG CTR, SUITE J, SAINT LOUIS, MO 63128-2761
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1154462950
—
MO
Enumeration date
06/30/2008
Last updated
06/30/2008
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