Organization
CENTER FOR ORTHOTIC & PROSTHETIC EXCELLENCE, LLC
Active
Other names
Center for Orthotic & Prosthetic Excellence, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
KENDRA F MICKELSON (MANAGER OF REVENUE CYCLE MANAGEMENT)
(309) 285-7752
Entity
Organization
Contact information
Practice address
11065 BROADWAY STE F, CROWN POINT, IN 46307-7302
(219) 365-0248
(219) 365-0072
Mailing address
741 W MAIN ST, PEORIA, IL 61606-1953
(309) 285-7752
(309) 285-7752
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
07/23/2024
Last updated
09/24/2024
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