Organization
ALBUQUERQUE ORTHOTICS & PROSTHETICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS LISA M URSO C.P.O. (OWNER/PROSTHETIST ORTHOTIST)
(505) 342-0333
Entity
Organization
Contact information
Practice address
4909 ELLISON ST NE, SUITE A, ALBUQUERQUE, NM 87109-4331
(505) 342-0333
(505) 342-0336
Mailing address
PO BOX 90445, ALBUQUERQUE, NM 87199-0445
(505) 342-0333
(505) 342-0336
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
FA0048723
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33680825
—
NM
05
—
957699
—
AZ
01
—
NMOOTA31
BLUECROSS BLUESHIELD NM
NM
Enumeration date
05/18/2007
Last updated
04/20/2008
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