Organization
BUCKEYE ORTHOPEDIC DESIGN, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARK BONDURANT CPO, LPO (PRESIDENT CLINICAL DIRECTOR)
(513) 770-5550
Entity
Organization
Contact information
Practice address
3187 WESTERN ROW RD, SUITE 106, MAINEVILLE, OH 45039-8045
(513) 770-5550
(513) 770-4190
Mailing address
3187 WESTERN ROW RD, SUITE 106, MAINEVILLE, OH 45039-8045
(513) 770-5550
(513) 770-4190
Taxonomy
Speciality
Code
Description
License number
State
222Z00000X
Orthotist
LPO 9
OH
224P00000X
Prosthetist
Primary
LPO 9
OH
335E00000X
Prosthetic/Orthotic Supplier
LPO 9
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2583262
—
OH
Enumeration date
11/01/2006
Last updated
01/22/2014
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