Organization
GREAT LAKES ORTHOTICS & PROSTHETICS INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PERRY L ALGER CO (PRESIDENT)
(920) 968-2240
Entity
Organization
Contact information
Practice address
3950 EVERGREEN CT STE A, APPLETON, WI 54913-8903
(920) 968-2240
(920) 968-2241
Mailing address
3950 EVERGREEN CT STE A, APPLETON, WI 54913-8903
(920) 968-2240
(920) 968-2241
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
41792000
—
WI
Enumeration date
06/17/2006
Last updated
06/09/2021
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