Organization
PONGRATZ ORTHOTICS & PROSTHETICS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICHOLE ANN INMAN CFM (PRACTICE MANAGER)
(602) 222-3032
Entity
Organization
Contact information
Practice address
595 N DOBSON RD, SUITE B32, CHANDLER, AZ 85224-4226
(480) 282-4499
(480) 615-1117
Mailing address
730 N 52ND ST STE 100, PHOENIX, AZ 85008-7987
(602) 222-3032
(602) 222-3506
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
AZ
332BC3200X
Customized Equipment (DME)
—
AZ
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
376435
—
AZ
Enumeration date
12/29/2005
Last updated
08/06/2021
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