Organization
MD ORTHOTIC AND PROSTHETIC LABORATORY, INC.
Active
Other names
Comprehensive Prosthetics & Orthotics
Organization subpart
No
Provider details
NPI number
Authorized official
DONALD GOERTZEN CPO (PRESIDENT)
(309) 676-2276
Entity
Organization
Contact information
Practice address
20060 GOVERNORS DR STE 102, OLYMPIA FIELDS, IL 60461
(219) 736-8896
(219) 293-8613
Mailing address
741 W MAIN ST, PEORIA, IL 61606-1953
(309) 676-2276
(888) 663-6322
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
07/20/2015
Last updated
07/30/2018
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