Organization
OHIO CUSTOM ORTHOTICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DON HAVEY (OWNER)
(314) 821-2600
Entity
Organization
Contact information
Practice address
2621 DRYDEN RD, STE 106, MORAINE, OH 45439-1661
(314) 821-2600
(888) 770-2935
Mailing address
17600 CHESTERFIELD AIRPORT RD, STE. 204, CHESTERFIELD, MO 63005-1246
(314) 821-2600
(888) 770-2935
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
—
—
Other
Enumeration date
03/08/2013
Last updated
03/08/2013
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