Organization
ORTHOTIC PROSTHETIC CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHARLES HALL C.O. (PRESIDENT)
(414) 875-9000
Entity
Organization
Contact information
Practice address
5310 W CAPITOL DR, SUITE 106, MILWAUKEE, WI 53216-2263
(414) 875-9000
(414) 875-9001
Mailing address
5310 W CAPITOL DR, SUITE 106, MILWAUKEE, WI 53216-2263
(414) 875-9000
(414) 875-9001
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1023974
UNITED HEALTHCARE ACM
WI
05
—
41611500
—
WI
Enumeration date
12/28/2006
Last updated
08/22/2020
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