Organization
M D PROSTHETIC LABS,L.L.C.
Active
Other names
Bossier City Prosthetic & Orthotic Lab
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JASON RALPH RIFFLE ABC CP BOCP (PROSTHETIST)
(318) 746-5000
Entity
Organization
Contact information
Practice address
4859 SHED RD STE 200, BOSSIER CITY, LA 71111-5493
(318) 746-5000
(318) 746-4000
Mailing address
4859 SHED RD STE 200, BOSSIER CITY, LA 71111-5493
(318) 746-5000
(318) 746-4000
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
20011
TX
335E00000X
Prosthetic/Orthotic Supplier
30
OK
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
LA
Other
Enumeration date
11/14/2007
Last updated
04/29/2008
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