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Organization

ALCHEMY ORTHOTICS AND PROSTHETICS

Active
Parent organization
ALCHEMY ORHTOTICS AND PROSTHETICS
Organization subpart
Yes

Provider details

NPI number
Legal business name
ALCHEMY ORHTOTICS AND PROSTHETICS
Authorized official
WILLIAM C SUNDBERG CPO, C. PED. (PRESIDENT)
(907) 562-0560
Entity
Organization

Contact information

Practice address
1405 KELLUM ST, SUITE 201, FAIRBANKS, AK 99701-4189
(907) 562-0560
(907) 562-1617
Mailing address
4048 LAUREL ST, SUITE 104, ANCHORAGE, AK 99508-5389
(907) 562-0560
(907) 562-1617

Taxonomy

Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
741113
AK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
PO4558
AK
Enumeration date
08/01/2012
Last updated
08/01/2012
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