Organization
RIVERSIDE ARTIFICIAL LIMB & BRACE CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. THOMAS A BARTCZAK CERTIFIED ORTHOTIST (PRESIDENT)
(951) 781-3011
Entity
Organization
Contact information
Practice address
4013 BROCKTON AVE, RIVERSIDE, CA 92501-3440
(951) 781-3011
(951) 781-4751
Mailing address
4013 BROCKTON AVE, RIVERSIDE, CA 92501-3440
(951) 781-3011
(951) 781-4751
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CGP124195
CCS
CA
05
—
GXC000440
—
CA
Enumeration date
10/05/2006
Last updated
08/22/2020
Update your record
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