Organization
PROSTHETIC DESIGN INC
Active
Other names
Orthotic & Prosthetic Design Inc
Organization subpart
No
Provider details
NPI number
Authorized official
MARK WILSON (OWNER/PRESIDENT)
(314) 535-5359
Entity
Organization
Contact information
Practice address
2665 SCOTT AVE STE E, SAINT LOUIS, MO 63103-3023
(314) 535-5359
(314) 535-5488
Mailing address
2665 SCOTT AVE STE E, SAINT LOUIS, MO 63103-3023
(314) 535-5359
(314) 535-5488
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
17156319
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
624794301
—
MO
Enumeration date
07/12/2005
Last updated
09/11/2024
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