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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