Organization
ORTHOTIC PROSTHETIC SPECIALISTS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICHOLE BROEDERLOW (BILLING MANAGER)
(219) 836-8668
Entity
Organization
Contact information
Practice address
625 RIDGE RD, STE D, MUNSTER, IN 46321-1695
(219) 836-8668
(219) 836-8778
Mailing address
625 RIDGE RD STE D, MUNSTER, IN 46321-1695
(219) 836-8668
(219) 836-8778
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200511990A
—
IN
05
—
300068651
—
IN
Enumeration date
06/15/2005
Last updated
03/13/2026
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