Organization
ORTHOMOLD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SAM IAFRATE (PRESIDENT)
(248) 889-4800
Entity
Organization
Contact information
Practice address
5575 JACKSON BLVD, WHITE LAKE, MI 48383-1919
(248) 889-4800
(248) 889-4800
Mailing address
5575 JACKSON BLVD, WHITE LAKE, MI 48383-1919
(248) 889-4800
(248) 889-4800
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
—
MI
Other
Enumeration date
10/04/2006
Last updated
07/21/2022
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