Organization
VALLEY ORTHOTIC INC.
Active
Other names
Valley Orthopedic, Inc
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH ALAN MANDLER L.C.O. CERTIFIED ORT (OWNER)
(509) 922-5040
Entity
Organization
Contact information
Practice address
11412 E. SPRAGUE AVE, SPOKANE VALLEY, WA 99206-5224
(509) 922-5040
(509) 922-5041
Mailing address
11412 E. SPRAGUE AVE., SPOKANE VALLEY, WA 99206-5224
(509) 922-5040
(509) 922-5041
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
600550953
WA
335E00000X
Prosthetic/Orthotic Supplier
Primary
600550953
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9562901
—
WA
Enumeration date
02/25/2007
Last updated
03/31/2011
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