Organization
VALLEY ORTHOTIC INC.
Active
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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