Organization
PROSTHETIC ORTHOTIC SPECIALIST INC
Active
Parent organization
PROSTHETIC ORTHOTIC SPECIALIST INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
PROSTHETIC ORTHOTIC SPECIALIST INC
Authorized official
MR. DONALD GOERTZEN CPO (PRESIDENT)
(309) 676-2276
Entity
Organization
Contact information
Practice address
3030 N WOODFORD ST, DECATUR, IL 62526
(217) 872-6150
(217) 872-6152
Mailing address
741 W MAIN ST, PEORIA, IL 61606-1953
(800) 334-5705
(888) 663-6322
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
08/06/2009
Last updated
07/30/2018
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