Organization
ACTIVE LIFE ORTHOTICS AND PROSTHETICS CORP.
Active
Organization
ACTIVE LIFE ORTHOTICS AND PROSTHETICS CORP.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PALLAVI NEMANI (COMPLIANCE OFFICER)
(512) 552-6311
Entity
Organization
Contact information
Practice address
8380 CERRILLOS RD STE 304, SANTA FE, NM 87507-4418
(505) 510-7171
Mailing address
124 ALVARADO DR SE, ALBUQUERQUE, NM 87108-2940
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
02/07/2017
Last updated
12/14/2023
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