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Organization

NORTH SHORE PEDORTHICS, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DEAN A. MASON CPED, BOCO CO (SINGLE MEMBER)
(440) 989-2799
Entity
Organization

Contact information

Practice address
4370 OBERLIN AVE, SUITE B, LORAIN, OH 44053-2942
(440) 989-2799
(440) 989-1127
Mailing address
4370 OBERLIN AVE, SUITE B, LORAIN, OH 44053-2942
(440) 989-2799
(440) 989-1127

Taxonomy

Speciality
Code
Description
License number
State
222Z00000X
Orthotist
Primary
LO 228 LPED 029
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2068622
OH
Enumeration date
10/30/2007
Last updated
07/14/2015
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